Mitral Valve Repair Surgery (Annuloplasty)

Overview

Annuloplasty is done to tighten the ring around the mitral valve. When the mitral valve ring is not as tight as it should be, blood can leak backward through the valve and disrupt normal blood flow.

Candidates for an annuloplasty

You may need to undergo an annuloplasty if:

• The ring around the mitral valve (annulus) has widened or otherwise changed from its usual shape
• Your heart has enlarged
• Your mitral valve is leaking

Preparing for an annuloplasty

Before undergoing the annuloplasty, you will need to avoid eating or drinking (fast) for up to 12 hours. Your doctor will let you know if you should continue to take your regular medications as prescribed.

Expectations from an annuloplasty

• Your surgeon will perform an annuloplasty using either open-heart surgery or minimally invasive heart surgery.
• Depending on your situation and needs, you may undergo other heart procedures in combination with the annuloplasty.
• For both minimally invasive and open-heart techniques, you will be under general anesthesia (fully asleep). These procedures are performed in a hospital.

Open-heart surgery
To repair the mitral valve, your surgeon sews a band to the ring around your mitral valve. The band consists of surgical mesh, plastic or metal; the band stays in place permanently. Once your surgeon has completed the annuloplasty and any other needed procedures, he or she uses stitches to close the incisions and covers the incision area with a bandage.

Minimally invasive heart surgery
With minimally invasive heart surgery, your surgeon can make multiple smaller cuts in your chest to access your mitral valve. Your surgeon inserts surgical tools with a tiny camera on its end into the incisions. The specialized viewing camera sees inside your body during the procedure. 

The band consists of surgical mesh, plastic or metal; the band stays in place permanently. Once your surgeon has completed the annuloplasty and any other needed procedures, he or she uses stitches to close the incisions and covers the incision area with a bandage.

Recovery from an annuloplasty

After the annuloplasty, you will spend several hours in a recovery area for close monitoring while the effects of anesthesia wear off. If your surgeon used minimally invasive techniques, you might only need to stay in the hospital for a couple of nights. If your surgeon performed open-heart surgery, you might need to stay in the hospital for up to a week after the annuloplasty.

Typically, those who undergo minimally invasive surgery recover more quickly than those who undergo open-heart surgery. The smaller incisions heal sooner and downtime is usually shorter. However, each patient is different and many factors can affect your healing and recovery. Your doctor will let you know when you can go back to work and resume your normal activities. 

When to seek care

If you think you may need to undergo this procedure, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a cardiologist for more specialized treatment.