Mitral Valve Replacement: Procedure, Risks, Recovery, and Outlook

Discover how mitral valve replacement treats heart valve disease, what to expect before, during, and after the procedure, and essential tips for a healthy recovery.

By Medha deb

Created on Sep 25, 2025

Discover how mitral valve replacement treats heart valve disease, what to expect before, during, and after the procedure, and essential tips for a healthy recovery.

Mitral Valve Replacement: What You Need to Know

The mitral valve is one of the heart’s four main valves, keeping blood flowing efficiently between the heart’s chambers. When it becomes faulty due to disease or damage, a mitral valve replacement can restore proper function, reduce symptoms, and protect your long-term heart health.

Understanding the Mitral Valve

The mitral valve acts as a gateway between the left atrium and left ventricle, opening to allow blood to move from the atrium to the ventricle and closing to keep it from leaking backward. Problems often arise due to:

Mitral valve regurgitation: The valve leaks, causing blood to flow backward into the atrium.
Mitral valve stenosis: The valve becomes narrowed and restricts blood flow.
Congenital defects, infection, or degenerative changes.

When repair isn’t possible, mitral valve replacement may be recommended to prevent complications such as heart failure, atrial fibrillation, or pulmonary hypertension.

When Is a Mitral Valve Replacement Needed?

You may need mitral valve replacement surgery if:

Your valve is too severely damaged or scarred for repair.
There is significant leakage (regurgitation) or narrowing (stenosis) causing symptoms or affecting heart function.
You have tried medications and other therapies without improvement.

Common causes prompting surgery include rheumatic heart disease, infective endocarditis, degenerative disease, or congenital abnormalities.

Types of Mitral Valve Replacement Valves

There are two main types of artificial valves used:

Mechanical valves
- Made from durable synthetic materials (like titanium or carbon).
- Last longer (often decades) but require lifelong blood-thinning medications to prevent blood clots.
- Often recommended for younger patients who can tolerate anticoagulants.
Biological (tissue) valves
- Made from animal tissues (often pig or cow, sometimes human donor tissue).
- Usually last 10–20 years; may eventually need replacement.
- May not require lifelong blood-thinning medication.
- Often suitable for patients who cannot take long-term anticoagulants or are older.

Your heart care team will recommend the best type for you based on your age, overall health, lifestyle, and preferences.

Different Approaches to Mitral Valve Replacement Surgery

Mitral valve replacement can be performed using several techniques:

Open-heart surgery: Traditional approach using a long incision through the sternum (breastbone) for full access to the heart.
Minimally invasive surgery: Uses smaller incisions (sometimes only 2–3 inches) on the right side of the chest; results in less pain, shorter hospital stay, and quicker recovery.
Robot-assisted surgery: Surgeons control robotic arms through small incisions, offering precision and faster recovery. A 3D camera provides comprehensive views of the heart.
Catheter-based procedures: For certain patients, devices like clips or plugs are delivered through a catheter, offering an option for those who can’t tolerate traditional surgery.

Comparison Table: Open vs. Minimally Invasive Valve Replacement

Feature	Open-Heart Surgery	Minimally Invasive/Robo-Assisted
Incision Size	6–8 inch (mid-chest)	2–3 inch (side of chest), or several small cuts
Recovery Time	About 6–8 weeks	Generally quicker (3–4 weeks)
Pain & Scarring	More pain and a longer scar	Less pain, minimal scarring
Hospital Stay	5–7 days	2–4 days
Suitability	Most patients, including with complex conditions	Not suitable for all; depends on individual factors

Preparing for Mitral Valve Replacement

Preparation is important for surgical success. Here’s what to expect:

Comprehensive evaluation: blood tests, imaging (echocardiogram, possibly cardiac MRI or CT), electrocardiogram (ECG).
Medication management: You may need to stop or adjust certain medications (especially blood thinners).
Fasting several hours before surgery, per your surgeon’s instructions.
A discussion with your surgical team about the specific approach, risks, and benefits.
Preoperative instructions on bathing, shaving, and cleansing the operating area.
Arranging for help at home after discharge.

You’ll receive general anesthesia for the procedure, ensuring you are asleep and pain-free throughout the surgery.

What Happens During the Surgery?

The specifics vary based on the chosen technique, but most surgeries follow these steps:

Anesthesia & Monitoring: An anesthesiologist administers general anesthesia. You are connected to monitors for heart and lung function.
Accessing the Heart:
- Open: The chest is opened via the sternum.
- Minimally invasive: Smaller incisions are made on the right side of the chest.
Heart-Lung Machine: Your circulation and oxygenation are maintained by a machine while the heart is temporarily stopped.
Valve Removal: The damaged mitral valve is carefully removed.
Valve Replacement: The new valve (mechanical or biological) is sewn into place.
Restarting the Heart & Closure: Heart function is restored, the heart-lung machine disconnected, and surgical incisions closed.

Surgery duration ranges from 2 to 4 hours on average, depending on the complexity.

Risks and Potential Complications

Mitral valve replacement is generally safe, but as with any major procedure, it carries risks:

Bleeding or blood clots
Infection (wound, lung, or heart)
Irregular heart rhythms (arrhythmias)
Stroke
Implant failure or leakage
Respiratory or kidney complications
Reactions to anesthesia

Your surgical team will discuss your individual risk profile before the procedure, taking into account age, general health, and other underlying conditions.

Recovery Process: What to Expect After Surgery

After surgery, you will typically:

Spend 1–2 days in the cardiac intensive care unit (ICU) for close monitoring.
Move to a regular hospital room for another 2–7 days, depending on progress and procedure type.
Be encouraged to gradually increase activity with the help of nurses and physical therapists.

During recovery you’ll be given instructions for:

Managing pain and preventing infection at the incision site.
Taking prescribed medications, including anticoagulants (blood thinners) if you have a mechanical valve.
Limiting activities like driving, lifting, or heavy exercise for several weeks per your doctor’s advice.

Full recovery can take 4–8 weeks for open-heart surgery, with shorter recovery times for minimally invasive cases. Participation in a cardiac rehabilitation program is often recommended for exercise, nutrition, education, and emotional support.

Life After Mitral Valve Replacement

After surgery, most people experience significant improvement in their quality of life and reduction of symptoms such as fatigue and shortness of breath. However, ongoing care is crucial:

Regular follow-up visits with your cardiologist to monitor valve function and heart health.
Medications, including blood thinners if you have a mechanical valve, to prevent clotting.
Antibiotics before certain dental or surgical procedures to reduce infection risk (endocarditis prophylaxis).
Lifestyle modifications such as healthy eating, physical activity, and quitting smoking.

Notify your doctor if you experience chest pain, shortness of breath, fever, or swelling, as these may indicate complications.

Mitral Valve Replacement vs. Repair: Key Differences

Repair: Preserves the existing valve; fewer lifelong medication needs; may reduce the risk of infection; may not be possible with severe damage.
Replacement: Necessary when valve is too damaged for repair; may require lifelong blood thinners (mechanical valve); more options for severely scarred, calcified, or infected valves.

FAQs: Frequently Asked Questions About Mitral Valve Replacement

Is mitral valve replacement a major surgery?

Yes, it’s considered major heart surgery. However, minimally invasive and robotic techniques can reduce the impact. Your team will advise on the best approach for you.

How long does a new mitral valve last?

Mechanical valves can last several decades but need lifelong anticoagulation.
Biological valves usually last 10–20 years, possibly less in younger, more active patients.

Do I have to take medications after valve replacement?

Yes, most patients require some medications, especially blood thinners if you have a mechanical valve. You may also need antibiotics before dental or other medical procedures.

What are the signs of valve failure or complications?

Persistent or worsening shortness of breath
Swelling in your legs or abdomen
Palpitations or irregular heartbeats
Unexplained fever (possible infection)
Chest pain

If you experience any of these, contact your doctor promptly.

Can I return to a normal life after surgery?

Most patients return to regular activities—including work and exercise—within a few months, especially if they participate in cardiac rehabilitation and follow medical advice.

Tips for Heart-Healthy Living After Mitral Valve Replacement

Attend all follow-up visits and keep your cardiologist informed of any symptoms.
Take all prescribed medications as directed, especially anticoagulants if you have a mechanical valve.
Adopt a heart-healthy diet low in salt, saturated fat, and cholesterol.
Engage in regular, moderate exercise as approved by your doctor.
Avoid tobacco and limit alcohol consumption.
Let your healthcare team know about any planned surgical or dental procedures.

Conclusion

Mitral valve replacement is a key treatment for severe valve damage, offering improved heart function and better quality of life for many patients. Talk with your cardiac care team about the procedure, recovery, risks, and how to achieve your best possible health after surgery.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

Read full bio of medha deb