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Mitral Valve Surgery

Before Surgery
You should be in the best possible health at the time of surgery. Your physician may recommend certain tests to rule out specific health problems prior to surgery.

Dental Exam
Good dental health helps prevent any infection in your mouth from spreading to your new or repaired valve. It is important to have your teeth cleaned and have a full dental exam to rule out infection before surgery. Tell your dentist that you will be having heart valve surgery. You will need to have a special X-ray (panorex) of your jaw. Your dentist will need to give you a letter stating you have had an exam and are cleared for heart surgery. Bring this letter to all of your presurgery appointments.

If you are unable to see your dentist, we can assist with scheduling.

Please note: Surgery may be delayed if you have any dental problems that require treatment.

Presurgery Appointments
Other presurgery appointments may include visits with a cardiologist, cardiac surgeon, nurse practitioner, behavioral medicine specialist, and preoperative assessment service.

• The behavioral medicine specialist will identify your risk factors for coronary artery disease, explain ways to reduce your risk factors and provide assistance with stress management, smoking cessation and preparation for upcoming surgery.

• The nurse practitioner will review important activities before and after surgery, details about medicines that may need to be discontinued before surgery and your arrival time on the day of surgery. These visits will include a thorough review of your health history and a physical exam. Our staff will assist you in scheduling the necessary appointments and tests.

For each appointment, please bring:

• A list of your current medications and allergies

• Questions for your physician and nurse practitioner

• Your medical insurance card

Tests
To determine the cause of your problem, your physician will review your health history and conduct a physical exam. During the exam, your physician will listen to your heart. One indication of valve disease is the presence of a murmur, an abnormal sound caused by turbulent blood flow across a valve. A heart murmur does not always indicate a heart valve problem. However, most abnormal heart valves cause a murmur.

• An echocardiogram uses high frequency sound waves to determine how the parts of the heart are working. This allows the physician to determine valve leakage or to measure the opening of a stenotic valve.

• A transesophageal echocardiogram (TEE) also uses sound waves to look at the heart and measure a valve opening or to determine leakage. This test differs from a standard echocardiogram because a probe is inserted into the esophagus. In this procedure, the probe sits directly behind the heart, allowing certain parts of the heart to be seen more clearly than with the standard test.

• A cardiac angiogram or cardiac catheterization looks at blood flow to the heart, helping detect the area and extent of any blockage or narrowing of the arteries. During the procedure, a thin tube is inserted into the femoral artery (located in the groin) and passed into the heart. Contrast dye is injected into the tube and X-rays are taken, allowing blood vessels and valves to be seen clearly on the X-ray.

• Cardiac magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create detailed images of the heart chambers, blood vessels, and valves.

If you have had these or other heart-related tests recently, please obtain copies of the test results and share them with your surgeon. In some cases, this may prevent repeat testing.

Medications
Certain medicines can increase your risk for bleeding during and after surgery. Talk with your surgeon if you are taking any blood-thinning (anticoagulant) medications such as warfarin (Coumadin®), heparin, Lovenox® or Plavix®. You also must stop taking nonsteroidal anti-inflammatory drugs such as Advil® or Motrin® prior to surgery.

Please contact your physician to confirm when to stop taking these medicines. This could be as little as two days or as long as 14 days before surgery. You must stop taking any aspirin or aspirin-containing products one week before surgery and any herbal medicines two weeks prior.

If you are diabetic, ask your physician whether you should take insulin on the day of surgery. Do not take any new medication without informing the prescribing physician about your impending surgery.

Recovering from Heart Surgery provides more detailed information about your hospital stay, homecare guidelines, and long-term follow-up care.

Contact
For more information regarding mitral valve disease and the treatments available, please contact the Bluhm Cardiovascular Institute at (866) 662-8467, or request an appointment online.

Visit the Northwestern Memorial Hospital's Health Learning Center and Alberto Culver Women's Health Learning Center. These state-of-the-art health information libraries are among the largest hospital-based learning facilities of their kind. For more information call (312) 926-5465.

Review Date: 08/07