By Michelle Pugle 

Published on September 27, 2023

 Medically reviewed by Richard N. Fogoros, MD

Mitral valve replacement surgery is a procedure for replacing a too-narrow, leaking or regurgitating, or otherwise damaged mitral valve. Four mitral valves in the heart are responsible for pumping blood from your heart to the rest of your body. Factors affecting recovery include age, if it's their first valve replacement, and lifestyle.

This article will explore long-term considerations of mitral valve replacement surgery and details what to expect regarding follow-up appointments, recovery timeline, and possible complications`.

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 Heart Valve Disease

Benefits of Mitral Valve Replacement

The benefits of mitral valve replacement surgery include:¹

• Increased energy for daily activities

• Improved mental health due to reduced symptoms

• Increased life expectancy at any age

• Reduced symptoms like heart palpitations, dizziness, shortness of breath, chest pain, fluid retention 

• Reduced risk of heart failure 

Mitral Valve Repair vs. Replacement

A mitral valve repair is less invasive than a mitral valve replacement and is the first line of treatment.² A replacement will be necessary in cases in which the damage is too severe for repairing with other heart tissue.

 Heart Valve Disease: Treatment Considerations

 Traditional Surgical Mitral Valve Replacement and Repair

Effect on Life Expectancy 

By definition, people who need mitral valve repair or replacement have a valvular heart problem that can be expected to cause life-altering symptoms, premature death, or both. By improving cardiac function in people with mitral valve disease, surgical procedures can improve life expectancy.

How well life expectancy is improved will depend on several factors, including age, the severity of existing cardiac damage, any other significant medical problems, and any additional surgical procedures necessary during mitral valve surgery.

One small, retrospective analysis published in the journal Medical Science Monitor on outcomes after mitral valve surgery in high-risk patients in their 80s found the majority underwent additional procedures at the same time, complicating our understanding of the direct effect of one procedure on life expectancy.³

 Does Mitral Valve Prolapse Cause Sudden Death?

Mitral Valve Surgery Follow-Up

Your surgeon will determine the best timeline for your first follow-up appointment depending on your pre- and post-op surgery considerations but you can expect stitches or staples will likely be removed at a follow-up appointment seven to 10 days post-op.⁴⁵

Keep all follow-up appointments, and contact your surgeon if you experience fever (temperature above 100.4 degrees F, or if your weight changes.⁵

Recovery Timeline

Most patients can return home three to seven days after surgery. It is recommended to continually follow up with your surgeon to check for any problems.⁴

Recovery timeline will also depend on type of replacement whether it is a transcatheter valve replacement or open heart procedure, and other factors including whether or not you experience depression, for example. 

The following is an expected recovery timeline after mitral valve replacement surgery:⁶

Day 1

You will feel groggy and confused but will be encouraged to sit up for the first time after surgery and possibly take your first steps by walking to the bathroom.

Days 1–3

While practicing self-compassion, continue to increase enjoyable activities. You can expect to be asked to shower and get dressed. The intravenous (IV) line and monitors will be removed. 

 What Is IV Therapy?

Days 5–10

This is a significant period of progress. Mobility will be encouraged but postsurgical depression symptoms can start showing up. Try not to be hard on yourself, connect with others, and talk to your healthcare provider or mental health professional if coping has become increasingly challenging. 

Weeks 2–3 and Beyond

Bearing in mind you’ll still need to rest to recover, you will start easing into a more structured, predictable schedule of activity again.

Blood clot prevention medication (blood thinners) will be necessary for a long time post-operation. People who have mechanical valves will need to continue taking blood thinners for life.⁷

Coping With Recovery

Up to 25% of people experience post-op "cardiac depression."⁸

American Heart Association. Post surgery milestones: Managing your mood, expectations and goals. 

 Coping with recovery may include recognizing how symptoms like irritability and extreme fatigue may be linked to depression rather than physical illness.⁹ Depression after surgery can occur for many reasons, especially if someone is already prone to experiencing depression.

If you’re experiencing depression for any reason, remember it's not uncommon and treatable. Some 80% to 90% of people with depression eventually respond well to treatment.¹⁰

 How Signs of Depression Feel and Look

Complications, Risks, and Continuous Monitoring

As with any surgery, there are risks of complications. It’s been said the risk of serious problems following replacement surgery is generally higher than with mitral valve repair.¹¹

At home, you’ll be monitoring the incisions for potential signs of infection. It’s normal to see some bruising. However, it’s time to contact your surgeon if you experience any of the following symptoms:¹²

• Increased pain

• Redness 

• Swelling

• Bleeding

• Fluid draining from incision 

• Fever and/or chills

• General malaise or feeling sick

Respiratory symptoms and complications and sepsis or infection have been the most frequently recorded postoperative complications across patient profiles.³

 Understanding the Risks Involved When Having Surgery

Repeat Hospitalization for Mitral Valve Replacement

Some people may require repeat hospitalization for mitral valve replacement. While it’s considered a high-risk operation, experts say it can be performed with acceptable results in carefully selected cases. However, long-term survival is considered better in people undergoing a repeat repair than a repeat replacement.¹³

Lifestyle Adjustments

Lifestyle adjustments will vary depending on your individual needs. The American Heart Association says anyone can benefit from the following after heart surgery:⁸

• Practicing habits for emotional and physical health (ie., socializing, balanced eating, exercising)

• Working on positive goals 

• Keeping realistic expectations

• Celebrating milestones along the way

Experts also suggest stopping smoking, limiting alcohol, managing stress, and maintaining a healthy weight.¹²

 Causes and Risk Factors of Heart Disease

Living With Heart Disease

Living well with heart disease is possible. In addition to maintaining a healthy and balanced lifestyle, here are some ways you can take action if you have heart disease:¹⁴

• Get cholesterol levels and blood pressure checked.

• Talk with your healthcare provider about whether or not daily Aspirin is right for you.

• Discuss medication options like statins with your healthcare provider.

 How to Increase Your HDL Cholesterol Levels

Summary

Mitral valve replacement surgery is a procedure that replaces a faulty heart valve. Benefits include increasing life expectancy, improving quality of life, and reducing risk of cardiac events like heart attacks. Maintaining follow-up appointments is important for recovery without infection and complications.

Postsurgical depression is not uncommon. Discuss symptoms or concerns with your surgeon or healthcare provider. Establishing healthy habits and making lifestyle adjustments is helpful to the recovery process, which takes several months.