What is a mitral valve replacement?

二尖瓣置换术是用人工二尖瓣替换工作不良的二尖瓣的手术. The mitral valve is 1 of the heart’s 4 valves. It helps blood flow through the heart and out to the body. 二尖瓣位于左心房和左心室之间. 你的医生会用一个人工瓣膜替换你工作不佳的二尖瓣. 这将确保血液可以流入左心室，然后正常地流出身体, without putting extra stress on the heart. 这篇文章关注的手术是使用传统的大切口来暴露心脏. 该切口比微创二尖瓣置换术的切口大.

Frequently Asked Questions About the Mitral Valve

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Why might I need a mitral valve replacement?

如果二尖瓣工作不佳，手术可能是必要的. 手术修复二尖瓣通常是可行的，但有时需要更换二尖瓣.

二尖瓣狭窄和二尖瓣返流(也称为二尖瓣功能不全)是两种不同类型的问题，可能需要更换瓣膜.

• In mitral valve stenosis, the valve is unable to open fully, 较少的血液能够从左心房进入左心室.
• In mitral valve regurgitation, the valve is leaky. 一些血液漏回左心房，而不是推荐十大正规网赌平台流到左心室.

这些瓣膜问题会导致疲劳和呼吸短促等症状. If these symptoms become severe, surgery may be necessary.

二尖瓣狭窄和二尖瓣反流均可由瓣膜老化引起. Other causes of mitral valve disease include:

• Ischemic heart disease (coronary artery disease)
• Infection of the heart valves
• Heart failure
• Rheumatic fever

What are the risks of a mitral valve replacement?

大多数接受二尖瓣置换术的人都有成功的结果, but there are certain risks. 你的具体风险会根据你的整体健康状况、年龄和其他因素而有所不同. Be sure to talk with your doctor about any concerns that you have. Possible risks include:

• Infection
• Bleeding
• Irregular heart rhythms
• Blood clots leading to stroke or heart attack
• Complications from anesthesia
• Continued leaking of the valve 
• Damage to nearby organs
• Memory loss or problems with concentration

Certain factors increase the risk of complications, like:

• Chronic illness
• Other heart conditions
• Lung problems
• Increased age
• Being obese
• Being a smoker
• Infections

How do I get ready for a mitral valve replacement?

As you plan for the surgery, 你和你的医生会决定哪种瓣膜最适合你. 你的外科医生会用生物瓣膜或机械瓣膜替换你的瓣膜.

• 生物瓣膜主要由猪、牛或人的心脏组织制成. Biological valves don’t last as long as mechanical valves
• Mechanical valves are man-made. If you receive a mechanical valve, 你将需要在你的余生中服用血液稀释药. Mechanical valves also have an increased risk of infection.

和你的医生谈谈如何为即将到来的手术做准备. Remember the following:

• 手术前避免在午夜之后吃或喝任何东西.
• Try to stop smoking before your operation. Ask your doctor for ways to help.
• You may need to stop taking certain medicines before your surgery. 如果你经常服用血液稀释药物，如华法林或阿司匹林，请遵循医生的指示.

你可能需要在手术前的下午到达医院. 这是一个很好的时机来问你关于手术的任何问题. 在手术前，你可能需要做一些常规检查来评估你的健康状况. These may include:

• Chest X-ray
• Electrocardiogram (ECG)
• Blood tests
• Echocardiogram
• Coronary angiogram (to assess blood flow in your heart arteries)

手术前一小时左右，医生会给你一些药，帮助你放松. In most cases your surgery will proceed as planned, but sometimes another emergency might delay your operation.

What happens during a mitral valve replacement?

Check with your doctor about the details of your procedure. In general, during your mitral valve replacement:

• A doctor will give you anesthesia before the surgery starts. 这将使你睡得更深，在手术过程中你不会感到疼痛. Afterward you won’t remember it.
• The operation will take several hours. 家人和朋友应该待在候诊室，这样外科医生就可以告诉他们最新情况.
• Your doctor will make an incision down the middle of your chest. To access your heart, your doctor will separate your breastbone.
• The surgery team will attach you to a heart-lung machine. This machine will act as your heart and lungs during the procedure.
• 你的外科医生会移除你现在的二尖瓣，用一个新的瓣膜代替.
• The surgery team will remove the heart-lung machine.
• The team will wire your breastbone back together.
• 然后医生会把你皮肤上的切口缝合起来.

What happens after a mitral valve replacement?

After your mitral valve replacement:

• 你将在重症监护室或康复室开始康复.
• When you wake up, you might feel confused at first. 你可能会在手术后几个小时醒来，或者稍晚一点.
• 大多数接受二尖瓣置换术的人在手术后发现症状立即缓解.
• 医生会仔细监测你的生命体征，比如你的心率. 他们可能会把你连接到几台机器上，这样护士就可以更容易地检查这些.
• You may have a tube in your throat to help you breathe. This may be uncomfortable, and you won’t be able to talk. Someone will usually remove the tube within 24 hours.
• You may have a chest tube to drain excess fluid from your chest.
• Bandages will cover your incision. These can usually come off within a couple of days.
• You will feel some soreness, but you shouldn’t feel severe pain. If you need it, you can ask for pain medicine.
• 再过一两天，你就能坐在椅子上，在别人的帮助下走路了.
• 你可以进行呼吸治疗，以帮助清除手术中积聚在肺部的液体.
• You will probably be able to drink the day after surgery. You can have regular foods as soon as you can tolerate them.
• 你可以穿上弹性长袜，帮助血液在腿部静脉中循环.
• 你可能需要在医院住5天左右.

After you leave the hospital:

• Make sure you have someone to drive you home from the hospital. You will also need some help at home for a while.
• 你可能会在7到10天的后续预约中拆除缝线或订书钉. Be sure to keep all follow-up appointments.
• 手术后你可能很容易疲劳，但你会逐渐开始恢复体力. It may take several weeks to fully recover from your surgery.
• After you go home, take your temperature and your weight every day. Tell your doctor if your temperature is over 100.4°F (38˚C), or if your weight changes.
• Ask your doctor when it is safe for you to drive.
• Avoid lifting anything heavy for several weeks. Ask your doctor about what is safe for you to lift.
• 遵循医疗保健提供者给你的所有用药说明, exercise, diet and wound care.
• 确保你所有的牙医和医生都知道你的病史. 在进行某些医疗和牙科手术之前，你可能需要服用抗生素，以防止瓣膜感染.

Next Steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• 谁来做测试或程序，那个人的资格是什么
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• 在测试或程序后，如果您有疑问或问题，可以打电话给谁
• How much will you have to pay for the test or procedure