Name of the Procedure:

Valvuloplasty, Mitral Valve, with Cardiopulmonary Bypass; with Prosthetic Ring

Summary

Valvuloplasty, mitral valve, with cardiopulmonary bypass using a prosthetic ring is a specialized heart surgery designed to repair the mitral valve. This procedure involves using a heart-lung machine to maintain circulation while a surgeon inserts a prosthetic ring to support the valve and ensure proper blood flow through the heart.

Purpose

This procedure addresses problems with the mitral valve, such as mitral regurgitation or mitral stenosis, which can lead to heart failure if untreated. The goal is to restore normal valve function, improve heart efficiency, and alleviate symptoms like fatigue and shortness of breath.

Indications

• Symptoms of severe mitral regurgitation (leakage of blood backward through the mitral valve).
• Mitral stenosis (narrowing of the mitral valve, restricting blood flow).
• Heart failure or other complications related to valve dysfunction.
• Poor response to medication or other less invasive treatments.

Preparation

• Patients may need to fast for 8-12 hours before the surgery.
• Adjustments or temporary cessation of certain medications as advised by the doctor.
• Preoperative tests include echocardiogram, electrocardiogram (EKG), chest X-ray, and blood work.

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made in the chest to access the heart.
3. The patient is connected to a cardiopulmonary bypass machine to take over heart and lung functions.
4. The heart is stopped temporarily, and the surgeon exposes the mitral valve.
5. A prosthetic ring is sewn into place around the base of the mitral valve to provide support.
6. The heart is restarted, and the patient is weaned off the bypass machine.
7. The incision is closed, and the patient is moved to the recovery area.

Duration

The procedure usually takes 3-5 hours, depending on the complexity of the condition.

Setting

Performed in a hospital operating room equipped with advanced surgical and cardiopulmonary bypass technology.

Personnel

• Cardiothoracic surgeon
• Anesthesiologist
• Surgical nurses
• Perfusionist (operates the heart-lung machine)

Risks and Complications

• Infection at the surgical site
• Bleeding or blood clots
• Stroke or heart attack
• Valve malfunction or failure
• Complications related to anesthesia
• Rare risks include damage to surrounding heart structures

Benefits

• Improved heart function and efficiency
• Relief from symptoms such as shortness of breath and fatigue
• Reduced risk of heart failure or other severe complications

Recovery

• Initial recovery in an intensive care unit (ICU) for monitoring.
• Hospital stay of about 5-7 days.
• Instructions for wound care, activity restrictions, and medications.
• Follow-up appointments for check-ups, echocardiograms, and cardiac rehabilitation.
• Full recovery typically takes several weeks to a few months.

Alternatives

• Medication to manage symptoms (though not a permanent solution).
• Less invasive procedures, such as balloon valvuloplasty, if appropriate.
• Mitral valve replacement, which involves replacing the valve entirely instead of repairing it.

Patient Experience

• The patient will be under general anesthesia and won’t feel pain during the procedure.
• Post-surgery, the patient may feel discomfort or pain managed with medication.
• Upon waking, the patient may have tubes and monitors attached, which will be removed gradually.
• The patient may experience fatigue and limited activity during the initial recovery period.
• Pain management includes medication, and comfort measures such as support pillows and gradual increase in activity levels.