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| {{Mitral stenosis surgery}} | | {{Mitral stenosis surgery}} |
| '''For the WikiPatient page for this topic, click [[Mitral valve surgery (patient information)|here]]''' | | '''For patient information, click [[Mitral valve surgery (patient information)|here]]''' |
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| '''For Mitral stenosis main page, click [[Mitral stenosis|here]]''' | | '''To go back to the main page on mitral stenosis, click [[Mitral stenosis|here]]''' |
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| {{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@perfuse.org] | | {{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org] |
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| ==[[Mitral stenosis surgery overview|Overview]]== | | ==[[Mitral stenosis surgery overview|Overview]]== |
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| ==[[Mitral stenosis surgery indications|Indications for Mitral Stenosis Surgery]]== | | ==[[Mitral stenosis surgery indications|Indications]]== |
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| ==[[Mitral stenosis surgery preoperative preparation|Preoperative Preparation]]== | | ==[[Mitral stenosis surgery preoperative evaluation|Preoperative Evaluation]]== |
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| ==[[Mitral stenosis surgery procedure|The Procedure]]== | | ==[[Mitral stenosis surgery procedure|Procedure]]== |
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| ==[[Mitral stenosis surgery recovery|Recovery]]== | | ==[[Mitral stenosis surgery recovery|Recovery]]== |
| '''Recovery at hospital'''
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| The patient may spend 4 to 7 days in the hospital after surgery (much less in Minimally invasive mitral valve surgery-3 to 5 days). Then patient will wake up in the [[intensive care unit]] (ICU) and recover there for 1 or 2 days. Two to three tubes will be in the patient's chest to [[drain]] fluid from around the heart. They are usually removed 1 to 3 days after surgery.
| | ==[[Mitral stenosis surgery outcomes and prognosis|Outcomes and Prognosis]]== |
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| The patient may have a [[catheter]] in the bladder to drain urine, and may also have intravenous lines to get fluids. Nurses will closely watch monitors that show information about the [[vital signs]] (pulse, temperature, and breathing).
| | ==[[Mitral stenosis surgery complications|Complications]]== |
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| The patient will be moved to a regular hospital room from the ICU. The nurses and doctors will continue to monitor the heart and vital signs until the patient is stable enough to go home. The patient will receive pain medicine to control pain around your surgical cut.
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| A nurse should help the patient to slowly resume some activity, and the patient should begin a physical therapy program to make the heart and body stronger.
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| A temporary [[pacemaker]] may be placed in the patient's heart if the heart rate becomes too slow after surgery.
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| '''Recovery at home'''
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| The patient should be informed about the following:
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| *Taking care for his or her healing incisions.
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| *Recognizing signs of infection or other complications.
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| *Coping with after-effects of surgery.
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| *Followup appointments, medicines, and situations when he or she should call the doctor right away.
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| *When he or she can go back to daily routine, such as working, driving, and physical activity.
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| After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling.
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| Other after-effects may include loss of appetite, problems sleeping, constipation, and mood swings and [[depression]]. After-effects usually go away over time.
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| Less recovery time is needed for off-pump heart surgery and [[minimally invasive]] heart surgery.
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| '''Ongoing care'''
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| Ongoing care after valve surgery may include periodic checkups with the doctor. During these visits, the patient may have blood tests, an [[EKG]] (electrocardiogram), [[echocardiography]], or a [[stress test]]. These tests will show how the patient's heart is working after the surgery.
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| Routine tests should be done to make sure the patient is getting the right amount of the blood-thinning medicine in case of mechanical valve placement.
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| The patient may be advised to change his or her lifestyle, this includes: quitting smoking, making changes to diet, being physically active, and reducing and managing stress.
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| ==[[Mitral stenosis surgery surgical outcome|Surgical Outcome]]== | |
| The results of mitral valve stenosis surgery are excellent in centers that regularly perform this surgery.
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| Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most patients, and they reduce recovery time and pain.
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| * Results of the commissurotomy should be assessed with hemodynamics and echocardiography.
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| * If second inflation is needed mitral regurgitation should be assessed.
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| * In general increasing valve area to greater than 1 cm2/m2 is an acceptable result.
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| * Usually the valve area doubles and the pulmonary pressures degrease immediately.
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| * 5 year survival is in the 90% range.
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| '''Mechanical versus biological valves'''
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| Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
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| [[Biological]] valves tend to fail over time <ref name="pmid8469251">{{cite journal| author=Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S| title=A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 18 | pages= 1289-96 | pmid=8469251 | doi=10.1056/NEJM199305063281801 | pmc= | url= }} </ref><ref name="pmid11028464">{{cite journal| author=Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH| title=Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. | journal=J Am Coll Cardiol | year= 2000 | volume= 36 | issue= 4 | pages= 1152-8 | pmid=11028464 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11028464 }} </ref>, but they have a lower risk of blood clots.
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| ==[[Mitral stenosis surgery possible complications|Possible Complications]]==
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| '''Risks of any surgery'''
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| *Blood clots in the legs that may travel to the lungs.
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| *Blood loss.
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| *Breathing problems.
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| *Infection, including in the lungs, kidneys, bladder, chest, or heart valves.
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| *Reactions to medicines.
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| '''Possible risks from having open-heart surgery'''
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| *[[Heart attack]] or stroke.
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| *Heart [[rhythm]] problems.
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| *Infection in the cut, which is more likely to happen in people who are obese, have [[diabetes]], or have already had this surgery.
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| *Memory loss and loss of mental clarity, or "fuzzy thinking."
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| *[[Post-pericardiotomy syndrome]], which is a low-grade fever and chest pain. This could last for up to 6 months.
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| '''Prosthetic heart valves are associated with a variety of complications'''
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| *Structural deterioration, particularly with bioprosthetic valves.
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| *Valve obstruction due to [[thrombosis]] or pannus formation.
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| *Systemic [[embolization]].
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| *Bleeding.
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| *[[Endocarditis]] and other infections.
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| *Left ventricular systolic dysfunction, which may be preexisting.
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| *[[Hemolytic anemia]].
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| ==[[Mitral stenosis surgery videos|Videos]]== | | ==[[Mitral stenosis surgery videos|Videos]]== |
| *'''Mitral valve replacement surgery animation'''
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| <youtube v=QBSKEAb7f2w/>
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| *'''Robotic mitral valve repair surgery animation'''
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| <youtube v=GYAmSH2zwic/>
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| ==Mitral stenosis surgery external links|External Links== | | ==External Links== |
| http://content.onlinejacc.org/cgi/content/full/52/13/e1
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| http://en.wikipedia.org/wiki/Mitral_valve#cite_note-0
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| http://en.wikipedia.org/wiki/Mitral_valve_stenosis
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| http://www.nlm.nih.gov/medlineplus/ency/article/000175.htm
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| http://www.nhlbi.nih.gov/health/health-topics/topics/hs/before.html
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| http://www.mayoclinic.org/mitral-valve-disease/
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| http://www.nlm.nih.gov/medlineplus/ency/article/007411.htm | | http://www.nlm.nih.gov/medlineplus/ency/article/007411.htm |
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| http://www.nhlbi.nih.gov/health/health-topics/topics/hs/during.html
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| http://www.nhlbi.nih.gov/health/health-topics/topics/hs/after.html
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| [[Category:Cardiology]] | | [[Category:Cardiology]] |
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| [[Category:Cardiac surgery]] | | [[Category:Cardiac surgery]] |
| [[Category:Surgical procedures]] | | [[Category:Surgical procedures]] |
| [[Category:Overview complete]]
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| [[Category:Template complete]]
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| [[Category:For review]] | | [[Category:For review]] |
| [[Category:Valvular heart disease]] | | [[Category:Valvular heart disease]] |
| | | [[Category:Up-To-Date cardiology]] |
| | [[Category:Up-To-Date]] |
| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |