Recovery After Mitral Valve Repair

After the mitral valve repair operation is completed, the patient is transferred to the intensive care unit for close monitoring.  Antibiotics are given to prevent infection, and pain is controlled with narcotic medications (frequently morphine).   After being stabilized in the ICU (approximately 1 day), the patient is then transferred to the cardiac surgery ward until ready to go home (approximately 4 days). 

After transfer from the ICU, the patient is encouraged to begin walking to start the healing process. The patient is initially started on a diet of clear liquids, which is increased to a full liquid diet and then a full solid diet that is low in cholesterol and sodium.  Intravenous medications are changed to oral medications in anticipation of discharge.   The patient is typically discharged around the fourth post-operative day.

Recovery at Home
After mitral valve repair surgery, the patient will gradually begin to feel better and return to normal activities.  Patients frequently have nausea and decreased appetite after mitral valve repair surgery and experience weight loss.  To prevent weight loss, try eating small frequent amounts of food, and take medications on a full stomach unless otherwise directed.  Depression, difficulty sleeping, and mood swings are common for a period of weeks to months after surgery.  You should speak with your physician if you experience these symptoms, especially if they become severe.  Although they are likely do decrease over time, there are medications that can help to minimize symptoms of depression. 

Constipation is also common after mitral valve repair surgery because of inactivity, limited fluid intake and lack of fiber. Constipation can be minimized by eating plenty of fiber and fresh fruits, drinking 6-8 glasses of water daily and using a stool softener.  All patients will feel pain after mitral valve repair, either at the site of incision and in the chest area.  Medications will be given to control this pain, which gradually resides over time.  If you remain in pain, you should speak with your physician.  Pain should be controlled by medications, and is important to your recovery.

Wound Care after Mitral Valve Repair
The surgical incision should be kept clean after mitral valve repair.  Your surgeon will give specific instructions for wound care.  It is generally safe to gently wash the incision with soap and warm water.  Any staples or sutures that remain at the incision site will be removed on your follow-up appointment.  You may shower after the staples have been removed, but should avoid soaking the incision until it has healed.  The incision will heal over time, and it is a good idea to keep the incision out of direct sunlight to prevent excessive scar formation.  Increased pain and redness at the incision site are signs of infection.  If these occur, you should notify your doctor immediately. 

Activity after Mitral Valve Repair
After mitral valve repair, a patient will gradually return to full activity.  Your physician or physical therapist will give you detailed instructions on when to begin activity, and how much activity you will be able to tolerate.  You should speak with your physician before beginning any activity to determine if it is safe.  After mitral valve repair, you will likely be enrolled in a cardiac rehabilitation program at your institution.  The program will provide detailed instruction that will allow you to regain your functional status as quickly as possible under the close supervision of health care professionals.

In general, walking is the first step in returning to full activity, and is important in rehabilitation of the heart.  The patient should begin walking when they feel able, and use their own judgment to determine how far and frequently to walk.  If you feel any chest pain, nausea, vomiting or shortness of breath, you should stop your activity and rest.  If the symptoms persist, you should notify your surgeon.  Sexual activity can resume when you feel comfortable, which may be 2 to 6 weeks after mitral valve repair surgery.  In general, activity should be light in the first 6 weeks, including light housework and walking as tolerated.  After six weeks, the patient will feel increased strength and may return to work.  After 3 months, the patient should be able to resume full aerobic activity.

Activities to avoid in the first 6 weeks include:
- Driving
- Lifting heavy objects
- Strenuous activity

Diet after Mitral Valve Repair
After mitral valve repair surgery, you will be placed on a specialized diet to assist in rehabilitation of your heart and to decrease the chance of further heart problems.  This includes a diet that is low in fat, sodium (salt), and cholesterol.  A low fat diet generally has less than 30% of all calories derived from fat.  Saturated fats and trans fats should be avoided, which include the fats found in butter, margarine, salad dressing, fried foods, snack foods, sweets, and desserts.  Monounsaturated fats are much healthier for the heart, and include fats found in olive and peanut oil. 

Sodium intake should be no more than 2400 milligrams per day, and you should try not to add table salt to your foods (as most diets are already high in sodium).  Optimal cholesterol intake should be less than 300 milligrams per day.  “Complex” carbohydrates (whole-wheat pasta, sweet potatoes, whole-grain breads) are much better for the heart, and foods with “simple” carbohydrates (regular soft drinks, sugar, sweets) should be limited.  Fish are a good source of protein, and contain omega-3 fatty acids. Omega-3 fatty acids may help reduce the risk of heart disease and stroke.  Other foods that help prevent further heart disease include vegetables, fruits, whole grains, and legumes.