Various surgical methods are available in Turkey to perform mitral valve replacement surgery as it is the only treatment option for some patients whose affected valve cannot be repaired.
An overview of the mitral valve
The mitral valve, also known as the mitral valve, is one of the four heart valves that allow blood to flow in only one direction. It is located between two of the left heart chambers - the left atrium and the left ventricle. It consists of two anterior and posterior leaves.

The mitral or mitral valve allows blood to pass from the left atrium to the left ventricle, which pumps oxygen-rich blood throughout the body and prevents it from returning in the opposite direction. Any damage to the valve function will lead to insufficient blood supply to the body.
There are two types of mitral valve problems:
- Mitral valve stenosis: The valve is stiff and calcified, and the valve leaflets may fuse partially with each other and not open completely, and this leads to insufficient blood passing from the left atrium to the left ventricle.
- Mitral valve insufficiency (mitral valve regurgitation): Occurs when the valve leaflets do not fit tightly when closing, which leads to leakage of an amount of blood from the left ventricle into the left atrium instead of heading to the arteries of the body, and failure may occur as a result of mitral valve prolapse.
These mitral valve problems may manifest with symptoms such as fatigue, shortness of breath, dizziness and chest pain, and if left untreated, the condition may develop into atrial fibrillation, pulmonary hypertension, or heart failure.
When the mitral valve injury is mild, the doctor may suggest some general tips to improve lifestyle and visit the clinic frequently for monitoring. He may also prescribe some medications that increase blood flow and improve the patient's symptoms.
Sometimes a doctor has to perform surgery to treat the mitral valve, and surgical options include Mitral valve repair surgery Mitral valve replacement surgery.
What are the indications for mitral valve replacement surgery?
Mitral valve repair and restoration is better than its replacement, and current guidelines recommend not changing the mitral valve except in cases that are not repairable, because the results of replacement are short-term and the patient will have to re-change the valve within 10-20 years.

However, the presence of significant calcifications in the valve annulus, degeneration of the valve tissue, inflammatory or septic changes in the valve, thickening or fusion under the valve, or cardiomyopathy may allow mitral valve replacement surgery in order to avoid the adverse consequences associated with some failed attempts to repair the valve coronary in such cases.
will Bimaristan Medical Center By referring you to the most skilled specialized doctors to look into your case and choose the most appropriate treatment technology for the case and the best hospital equipped with modern equipment and technologies to carry out the operation in it.
Types of replacement mitral valves
Mitral valve replacement surgery is based on replacing the damaged valve with another valve. There are two main types of mitral valve replacements, each with special features and indications that depend on the patient’s age, health condition and lifestyle, they are prosthetic (mechanical) valves and biological valves.
Although the artificial valves push the patient to take blood thinners, and the associated increased risk of bleeding, the studies Emphasizes that both types of valves have the same result in the long run.
prosthetic valves
They are valves made of metal, carbon or plastic that last for about 20-30 years, but the patient will need to take blood-diluting drugs throughout his life due to the risk of blood clots forming when using this type of valve.
vital valves
They are valves made of human or animal tissue that last about 10-15 years or less when used on children and young adults. They have a shorter life than artificial valves, but they do not need to take blood thinners that increase the risk of bleeding.
Mitral valve replacement surgery risks
Most of the mitral valve change operations are successful, but there are always risks and complications from any surgery, and the risk of the surgical procedure generally depends on the patient’s general health, age and some other factors.
Some potential risks of mitral valve replacement surgery:
- Bleeding and sepsis
- Arrhythmia
- Formation of blood clots that may lead to a heart attack or stroke
- Complications from anesthesia
- Death
Death during mitral valve replacement surgery is uncommon, and has been demonstrated studies The death rate is estimated at 6% in all patients who underwent mitral valve replacement surgery, regardless of risk factors.
Some factors that increase the risk of the surgical procedure:
- chronic diseases
- Other heart problems
- pulmonary problems
- aging
- obesity
- Tobacco
- infections
How to perform coronary heart valve replacement surgery in Turkey
When the patient decides to have a mitral valve replacement surgery, he must stop smoking for several weeks before the operation and tell his doctor about the medications he is taking and stop eating starting from midnight before the operation.
Upon arrival at the hospital, some routine examinations and tests will be performed to ensure the patient’s health before the operation. These examinations include a simple chest X-ray, echocardiogram, electrocardiogram and blood tests.
At the beginning of the operation, the patient will be placed under general anesthesia in order to sleep deeply and not feel pain during surgery. It should be noted that there are two ways to reach the heart in order to change the mitral valve: open heart surgery Minimally invasive heart surgeryThe doctor chooses the most optimal and least dangerous procedure for the patient.
Mitral valve replacement by open surgery
The surgeon makes a wide incision in the sternum longitudinally to reach the heart, then the cardiopulmonary bypass device is connected directly to the patient's heart.
The bypass machine functions as the heart and lungs to pump and oxygenate the blood while the heart is temporarily stopped so that the surgeon can replace the affected valve.
An incision is made in the left atrium of the heart to access the mitral valve, then the damaged leaflets are removed before the new mitral valve is implanted.
After installing the valve in place, the left atrium is closed and the heart is revived to start pumping blood, and after making sure that the new valve is working, the chest is closed by electrode and wire.the video.
Minimally Invasive Mitral Valve Replacement
In this procedure, the mitral valve that is not working well is replaced with another valve without the need for an open heart operation, and it is called minimally invasive because it requires small surgical incisions and is done using specialized tools instead of the large incision used in the traditional operation.
The surgeon performs minimally invasive surgery whenever possible, because minimally invasive surgery has several benefits and features that make it preferable to open surgery, including:
- Smaller incisions and therefore better cosmetic results
- Less risk of bleeding and infection
- Less pain after the operation
- Shorter hospital stay
- Recover from the operation and get back to work faster
and indicate studies until open heart surgery orMinimally invasive surgery They have the same therapeutic results on the mitral valve.
There are many ways to perform a minimally invasive mitral valve replacement, either the surgeon performs the operation through one small incision between the ribs or several incisions, or he performs it without any incision in the chest!
Here are some of the techniques used to perform a minimally invasive mitral valve replacement:
Right Mini-Thoracotomy
In this technique, the surgeon makes a small incision 2-3 inches (5-7 cm) long between the ribs in the right chest (specifically in the right fifth intercostal space) called the keyhole, and the operation is performed through it, in addition to several other incisions on the anterior axillary lines And the right posterior to insert the endoscope and forceps, so it is also called laparoscopic mitral valve replacement.
The cardiopulmonary bypass machine is inserted through a small incision in the groin so the surgeon can stop the heart and change the valve.
The soft tissue retractor is used to remove and stabilize the ribs so that the surgeon can insert the instruments for the operation. The operation is performed with the help and guidance of the endoscope, which provides a precise and direct view of the mitral valve.
By using this technique, the patient can preserve the bones of the rib cage without any damage, which ensures the stability of the chest. In addition, this technique speeds up recovery after the operation and the resulting surgical scars are almost invisible.

By Robotic-Assisted
It is the least invasive technique in the chest, where the mitral valve is changed through 2-4 small incisions 1-2 cm long to insert robotic arms controlled by the surgeon through a special computer in the operating room.
A 3D image of the heart and mitral valve is displayed on this computer allowing the surgeon to perform the procedure by looking at the screen and controlling the robotic arms from a distance.
As in the previous technique, the cardiopulmonary bypass machine is inserted through a small incision in the groin to stop the heart.
Transcatheter TMVR
In this technique, a catheter tube with a balloon at the end is inserted and carries the replacement valve through a large vessel (usually in the groin) to the heart.
When the catheter reaches the site of the mitral valve, the balloon is inflated to remove the old valve and put the new valve in its place. The new valve is then installed in place.
Compared to other minimally invasive techniques, catheter mitral valve replacement is a non-invasive technique that is performed without stopping the heart.
Minimally invasive techniques, especially transcatheter mitral valve implantation, are among the most promising techniques in the medical field, which will revolutionize the field of mitral valve replacement, as she explained. studies.
Recovery after mitral valve replacement surgery
Immediately after the operation, the patient is transferred to the intensive care unit in order to be monitored and to ensure that there are no complications, and he stays there for one or two days, then he is transferred to a normal room in the hospital for about a week until he can get out of his bed.
The patient may feel tired and sore in the first weeks after the operation and often these symptoms improve within 4-6 weeks, but most patients after the operation will notice a direct improvement in the symptoms they had before the operation.
The patient will be able to do many daily activities after 4-6 weeks of the operation, but before this period he should not carry heavy things and not do any strenuous activity for the chest or upper limb muscles.
A patient who has had a mitral valve replaced with a prosthetic valve will need to take blood-thinning medications (such as warfarin) for life to prevent blood clots from forming.
It is also necessary for the patient to eat a healthy, balanced diet, to exercise regularly to help him recover, and to stop smoking if he is a smoker.
It should be noted that the recovery time varies from one patient to another depending on his health condition before the operation, his commitment to the doctor's instructions and the type of operation performed.
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