Potential Complications Following Mitral Valve Replacement Surgery

Undergoing mitral valve replacement surgery can significantly improve a patient's quality of life, but like any major cardiac procedure, it comes with potential risks. Below are some of the complications that may occur following mitral valve replacement.

Low Cardiac Output Syndrome

One of the most common complications after mitral valve replacement is low cardiac output syndrome. This condition occurs when the heart is unable to pump enough blood to meet the body's needs. Contributing factors may include weakened myocardial function, metabolic acidosis, and severe arrhythmias. Prompt identification and treatment are essential to prevent further complications.

Left Ventricular Free Wall Rupture

This is a rare but life-threatening complication that can occur after mitral valve surgery. If the left ventricular wall ruptures, it often leads to acute cardiac tamponade and carries a mortality rate of over 95%. Early detection and emergency surgical intervention are critical for survival.

Thromboembolic Events

Blood clots can form following valve replacement, particularly if anticoagulation therapy is not properly managed. Risk factors include atrial fibrillation, an enlarged left atrium, and reduced left ventricular function. These clots can travel to vital organs, causing stroke or systemic embolism, making effective anticoagulant management essential.

Postoperative Bleeding

Bleeding is another significant concern after surgery. It may result from excessive anticoagulant use or drug interactions, such as when antibiotics interfere with blood thinners. Close monitoring of coagulation parameters and medication adjustments are crucial in minimizing this risk.

Mechanical Valve Dysfunction

Artificial valves can sometimes malfunction. This may include mechanical issues such as valve obstruction (thrombosis or pannus formation) or paravalvular leakage. Regular follow-up and echocardiographic assessments are important to ensure the valve functions correctly.

Infective Endocarditis

Prosthetic valve endocarditis is a dangerous infection that can develop after surgery. The risk is approximately 3% within the first year and increases by about 0.5% annually thereafter. This infection can severely damage the heart valves and has a mortality rate of nearly 50%, requiring aggressive antibiotic therapy or even repeat surgery.

Other Possible Complications

In addition to the more serious complications, patients may experience infections at the surgical site, pneumonia, or urinary tract infections. These are generally less severe but can prolong hospitalization and delay recovery if not promptly treated.

While mitral valve replacement is a major procedure, understanding the potential complications allows patients and healthcare providers to take preventive steps and respond quickly if issues arise. Regular follow-up and adherence to medical advice are key to a successful recovery.