Mitral valve replacement is a cardiac procedure in which the diseased mitral valve, the bicuspid valve regulating one-way blood flow from the left atrium to the left ventricle, is replaced with a prosthetic valve when its leaflets and supporting apparatus can no longer be repaired. It is indicated in severe mitral s…
Mitral valve replacement is a cardiac procedure in which the diseased mitral valve, the bicuspid valve regulating one-way blood flow from the left atrium to the left ventricle, is replaced with a prosthetic valve when its leaflets and supporting apparatus can no longer be repaired. It is indicated in severe mitral stenosis or regurgitation arising from rheumatic heart disease, degenerative myxomatous change, in which leaflets thicken and prolapse with altered connective-tissue and cartilage-related protein expression, infective endocarditis, annular calcification, or ischaemic damage to the subvalvular structures. Surgeons may implant a mechanical prosthesis, which is durable but mandates lifelong anticoagulation, or a bioprosthetic tissue valve, which limits anticoagulation needs but degenerates over time; repair is preferred when feasible because it preserves native architecture and ventricular function. The operation is typically performed through open or minimally invasive access with cardiopulmonary bypass, and transcatheter mitral techniques are expanding for selected patients. Particular attention is given to high-risk groups, including pregnant women with valvular disease in whom hemodynamic and anticoagulation management is complex. Echocardiography and clinical follow-up monitor prosthetic function, paravalvular leak, thrombosis, and endocarditis, while postoperative care addresses anticoagulation, arrhythmia, and ventricular recovery.
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