Mitral Valve Replacement Surgery

Mitral Valve Replacement Surgery

Mitral Valve Replacement - Causes, Symptoms, Success Rate & Transplant Cost in India

The Mitral valve replacement is a procedure performed to replace a damaged mitral valve with either a mechanical valve or a biological valve. The mitral valve is one of the 4 valves present in the heart. This valve is responsible for blood flow from the left atrium to the left ventricle. The position of the mitral valve lies between the left atrium and the left ventricle, hence it allows blood circulation from the left atrium towards the left ventricle. It also prevents the blood from flowing backwards into the left atrium.

When the mitral valve is no longer serving its function, you may be immediately recommended to get a Valve Replacement Surgery done. Untimely or delayed Valve Repair treatment may lead to a worsening of the heart function, thereby leading to heart failure and eventually death.

What are the Types of Mitral Valve Disease?

Mitral Valve Replacement is a surgery done when the mitral valve does not work properly. The mitral valve disease can be caused by several conditions, however, the first two cases mentioned below are majorly responsive for mitral valve disease:

  • Mitral Valve Stenosis: It happens when the valve is not able to properly open. It is caused when the flaps of the valve become thick and hard due to calcification which results in hardening of the leaflets, hence preventing the mitral valve’s movement.
  • Mitral Valve insufficiency: It happens when the valve does not properly close. Because of this the blood flows backwards into the left atrium. Hence it results in leakage of blood due to which not enough blood is able to flow in the body.
  • Ischemic heart disease (coronary artery disease): Inadequate blood flow due to weakening of the heart is referred to as Ischemic heart disease. It is connected to the damaged valve.
  • Endocarditis: The inflammation in the heart chambers and heart valves is referred to as endocarditis. This happens due to bacterial or fungal infection in the damaged areas of the heart.
  • Heart failure: Heart failure can be the result of severe mitral valve insufficiency.
  • Rheumatic mitral valve disease: When rheumatic fever results in damaging the mitral valve, it is known as rheumatic mitral valve disease.

What are the Indications You Need a Mitral Valve Replacement?

The symptoms of mitral valve disease develop over time as the damage to the valve increases over time. Here are a few symptoms of mitral valve disease:

  • Abnormal heart sound (heart murmur) that can be heard through a stethoscope
  • Chest pain (angina) or tightness within the chest
  • Feeling faint/dizzy or fainting as a result of activity
  • Shortness of breath, especially out of an activity
  • Fatigue, especially during times of increased activity
  • Swollen feet or Legs
  • Abnormal Blood Pressure
  • Incessant coughing
  • Heart palpitations and convulsions: sensations of a rapid, fluttering heartbeat
  • High Blood Pressure

Types of Valves Used in Artificial Mitral Valve Surgery

There are mainly two types of valves that the heart surgeon may use during the Valve Replacement surgery. Depending on the condition of your Mitral Valve Disease, your heart surgeon may decide which valve to choose.

1. Mechanical Valves:

These are made of artificial elements like Titanium, Teflon, Carbon. They last a long time and don't wear off in the body after replacing the original mitral valve. However, after the implantation of Mechanical valves in the body, your doctor may advise you to take blood-thinning medication for the rest of your life.

2. Biological Valves:

As the name suggests they are made of composite or bio-prosthetic materials, often extracted from animal tissue of a cow or a pig. These valves, however, have a lifetime of 15-20 years, which means you may be required to get a second valve replacement done later. These valves may not require you to consume blood-thinning medicines. Biological valves are more commonly used in valve replacement operations than mechanical valves.

Best Mitral Valve Replacement Doctors in India

1. Dr. T S Kler


2. Dr. Ashok Seth

Dr Ashok Seth - Best Cardiologist in India

3. Dr. Naresh Trehan


4. Dr. Kewal Krishan

Dr Kewal Krishan - Heart Transplant and LVAD Heart Surgeon in India

Mitral Valve Replacement Surgery - A Brief Idea of How it is Operated

Before your Valve Replacement Surgery, a strong dose of general anesthesia is administered to you to put you into a deep sleep until the surgery is completed. As soon as you are in a deep sleep, your surgeon will proceed with the procedure. The nurse will shave and sanitize the skin on your chest.

Your surgeon will make an incision on your chest, cut around the breastbone, and spread the ribs to reach the heart. To accomplish the operation, the doctor needs your heart to be stable. To achieve this, your heart needs to be stopped temporarily. This can be achieved by using a heart-lung bypass machine. The machine is connected to your heart and it will keep the normal pumping of the blood just like the original heart does.

Your surgeon will remove the diseased mitral valve and replace it with either a mechanical (artificial mitral valve) or bio-prosthetic valve. The surgeon ensures that all the connections to the valves are properly fixed. Once the operation is completed, your surgeon will take you off the heart-lung bypass machine and your heart starts pumping normally. The incision is then closed with the stitches.

During the Mitral Valve Replacement Operation

There are different approaches to perform the surgery. Your surgeon will decide which approach to choose based on what treatment you need.

In most of the cases, your surgeon will operate by open Mitral valve replacement operation. In this process, your doctor will make an incision of about 3 to 5 inches on the chest and cut through the breastbone, spreading the muscles and reaching the heart.

Your heart is connected to a heart-lung bypass machine which will regulate the normal pumping of your heart while your heart is temporarily stopped to perform the surgery. Once the valve is replaced, the breastbone is connected by stainless steel wires, and the incision on the chest is stitched with the sutures.

Another approach to operate the Mitral valve replacement is by minimally invasive mitral valve surgery which is also known as transcatheter mitral valve replacement. In this procedure, instead of one big cut, your surgeon will make multiple (1 to 4) cuts on the chest and the procedure is performed by using special tools and a camera to guide the surgeon.

Recovery after Artificial Mitral Valve Surgery

After your Valve Replacement surgery, you may have to spend a few days in an intensive care unit (ICU) of a hospital where the nurses will keep you under observation. Your heart rate, oxygen, and breathing will be continuously monitored.

Your doctor may prescribe you medications to prevent arrhythmias- irregular heartbeats which is one of the common side effects after valve surgery. Your doctor may also prescribe you an anticoagulant drug to prevent blood clots. You will have to consume this medicine for up to 3 months if you have received a biological valve, and if you have received a mechanical valve, then you will have to consume this medicine for a lifetime.

Full recovery from Valve Replacement treatment can take several months, which will come through the healing of the incision, rebuilding physical endurance, and regular exercising. For the first few weeks, you may feel tired and would be strictly advised to avoid physical exertion. The usual side effects of the Valve Replacement surgery may take up to a few weeks to subside.

You will probably start to feel better nearly immediately. You will note that each day brings a slight improvement in how you feel, as your condition will progressively improve over time. To obtain the full benefits of mitral valve repairs, you must change your daily routine. You need to take some preventative measures if you do not want the condition that affects your heart valves to flare up again.

Post Mitral Valve Replacement Surgery Aftercare

Be careful to keep your follow-up appointments with your primary care physician. You will get directions on how to take your medication, when to take it, what activities are appropriate for you to participate in, and which ones you should avoid.

Repairing a heart valve may leave you feeling as if you need to make significant adjustments to how you live your life. Following surgery, you will most likely experience a significant improvement in your physical well-being, which should last for many weeks or months. As you start to feel better, you should probably talk to your doctor about some of the details of this information further.

The following pieces of sound medical advice should be followed for the best possible result after having a heart valve replaced:

  • Follow the precise dosage instructions for all drugs, including those you may not have used before, such as blood thinners.
  • Obtaining an adequate amount of sleep.
  • Taking the prescribed aftercare measures for surgical incisions.
  • Ensuring that you keep all of your regular appointments with the lab and the doctor may involve diagnostic procedures to assess how well your replacement valve is working and bloodwork to determine how well your medication is working.
  • Taking part in recommended activities, such as going on walks, without going to extremes.
  • Expect to go back for regular checkups even after you have made a full recovery and may even feel like a new person. This is necessary to ensure that your heart valves and overall health remain in good condition.
  • You must maintain these visits to discover any potential issues at an early stage when it is often the simplest to address them.

Mitral Valve Replacement Surgery in India

A scientific review published in December 2023 shows that the prevalence of valve disease in African countries is considerably high. The studies are carried out in countries like Rwanda, Nigeria, Ghana, Ethiopia, Tanzania, etc. It also says that the overall mortality rate is 10.48%. The healthcare system is still improving in developing countries.

In India, the medical facilities of the hospitals including good post-operative care ensure successful treatment. As compared to other countries, India provides premium healthcare facilities and is very cost-effective. Many people from other countries travel to India for healthcare treatment every year.

Cost of Mitral Valve Replacement Surgery in India

The cost of the surgery depends on many factors such as the type of severity of a condition, the total cost of medications, the chosen hospital and its location, the charges of your surgeon, etc. However, the Mitral Valve Replacement cost in India is approximately 7000-7500 USD whereas it costs 40,000 – 200,000 USD in the US and 44,768.50 USD in the UK. Hence, the total cost of Heart Surgery in India is much more affordable compared to other countries.

What is the Success Rate of Valve Replacement Surgery in India?

The success of any surgery depends upon various factors. Some of them are: the age of the patient, the expertise of the surgeon, patient’s health condition and lifestyle, etc. However, the success rate of this surgery in India is 98%. The studies show that about 95% of people don’t need a reoperation after 10 years and 90% of people don’t need reoperation after 20 years.

Mitral Valve Replacement Surgery FAQs

Is there a difference between the mitral valve and the bicuspid valve?

The mitral valve is also known as the bicuspid valve as it has 2 flaps/cusps just like the tricuspid valve has 3 flaps/cusps. It is present between the left atrium and left ventricle. The bicuspid valve is responsible for preventing the blood from flowing backward.

What factors lead to mitral valve dysfunction?

Rheumatic heart illness is one of the primary contributors to the development of mitral valve stenosis. At this point, an infection is responsible for causing inflammation of the heart. It is possible that, over some time, the mitral valve's flaps may grow rigid and thick.

How risky is valve replacement surgery?

Surgery on the valve replacement comes with significant risks, just like any other surgical operation. Some of the most significant risks connected with mitral valve surgery include the possibility of having a stroke, having a pacemaker implanted, having renal failure, lung failure, and having a wound infection. Fortunately, instances like this are relatively rare.

What happens if the mitral valve doesn't work correctly?

When mitral valve insufficiency mitral valve regurgitation is severe, the heart needs to work harder to pump sufficient blood to the rest of the body. The additional work leads the left ventricle, the bottom chamber of the heart, to enlarge. If not addressed, the muscles of the heart will grow weak. This can lead to the heart giving out.

How long does heart valve surgery take, and why does an individual need it?

Depending on your valve condition, the surgery can take from 3 to 5 hours. The most common reason an individual will need valve surgery is to repair the leaky valve. It is also called Mitral Insufficiency.

How must I stay healthy after heart valve replacement surgery?

Take all prescription drugs as directed. In addition, inform your doctor when you experience sudden fever, unexpected weight gain, discomfort, or any other symptoms. If your physician advises a low-salt diet, adhere to it. Follow your physician's recommendations for exercise and other activities. Last but not least, inform your doctor of any changes to your lifestyle.

How costly is valve replacement surgery in India?

Heart Valve Replacement Surgery costs between USD 6,200 and USD 8,200 on average in India. This expense can be lower or higher depending on the hospital, the doctor's experience, the type and quality of implant used, and many other factors.

How will this procedure affect my life?

After 4 to 6 weeks, you can do many things you usually do. However, you should avoid lifting heavy items or doing something that stains your upper arm muscles or chest for at least six weeks.

How risky is this procedure?

The success rate of this procedure in India is 98%. This suggests that there is only a 2% chance of risk. That too if the patient already has some other health conditions or because of old age. If the patient is maintaining a healthy lifestyle then there is no need to be afraid of any adverse effects.

How does mitral valve insufficiency develop?

Mitral valve insufficiency is usually mild and progresses slowly. A few individuals with mitral valve insufficiency may not experience any symptoms for a long time. Yet occasionally, mitral valve insufficiency occurs fast. This situation, known as acute mitral valve insufficiency, shows sudden signs and symptoms.

Does mitral valve prolapse cause shortness of breath?

Yes, having trouble breathing or feeling short of breath, especially when exercising or lying down, maybe a sign of mitral valve prolapse.
Further, if you have signs of mitral valve prolapse, you should make an appointment to consult your doctor. Many other things can cause the same symptoms. However, if you've been diagnosed with mitral valve prolapse and your symptoms worsen, you should see your doctor.

What is the duration of the valve replacement surgery?

The mitral valve surgery takes about 1 to 4 hours. It totally depends on the severity of the condition and whether you need valve repair or valve replacement surgery.

Does India provide additional services to international patients?

Yes. India provides special services to international patients. The patients traveling to India for any healthcare service are provided with premium service, and the team of your selected organization is there with you in every step of the treatment. India provides superior care, different treatment packages, a free 2nd option to select a doctor, language assistance, visa assistance, special food, logistic support, follow-up services, and clinical camps.

Can I have an X-ray after having my valve replacement surgery done?

Yes. It is safe to get an X-ray after going through this procedure. The valve products are safe. However, you must talk to your doctor before making any decision.

Can I go for an MRI scan after this surgery?

Yes. You can have an MRI scan. The valve replacement products are tested and are compatible with MRI scans. However, you must talk to your healthcare provider before making any decision.

Is mitral valve surgery and open heart surgery the same?

The valve replacement surgery requires cutting open the chest in the same manner as open heart surgery. So it can be said that the valve replacement surgery is performed through open heart surgery.

Is it possible to replace the heart valve without open heart surgery?

Yes, minimally invasive valve replacement surgery is a procedure that is performed to replace the valve without making a large incision.

Is valve repair a better option than valve replacement?

Well, it depends on how damaged your valve is and how much repair it needs. Most doctors suggest valve repair procedures over replacement as it is much better to keep your own valve. However, your doctor may suggest you for valve replacement if the condition is severe.