The mitral valve is one of the heart’s four key valves. It is located between the left atrium and the left ventricle. It has two thin flaps that open and close with each heartbeat. When the heart relaxes, the valve opens so blood full of oxygen can move from the left atrium down into the left ventricle. When the heart squeezes, the valve closes to stop blood from going backward.
In a healthy heart, blood flows one way, smoothly. But if the valve or the strings that support it are damaged, that can change. At times, the valve fails to shut completely. That’s called mitral regurgitation, and it causes blood to leak back into the atrium.
Other times, the valve doesn’t open wide enough. That’s called mitral stenosis, and it slows down the blood trying to move forward.
Both problems make the heart work harder. If left untreated, they can lead to symptoms like tiredness, shortness of breath, or even heart failure. These valve issues usually take years to show up. But once they get worse, they can put real strain on the heart. If the valve becomes very leaky or too tight, surgery is often the next step. Most of the time, mitral valve surgery is needed because of a leaky valve caused by prolapse. Fixing the valve—either repairing it or replacing it—can ease symptoms and help the heart work better.
This guide will help you understand the differences in mitral valve repair vs replacement, the pros and cons of each, and what to expect after surgery.
The mitral valve repair procedure typically involves reshaping the flaps, reinforcing the valve base, and correcting supporting structures like the chordae tendineae.
Mitral valve repair means fixing your own valve so it works like it should. Most of the time, this is done with open-heart surgery, though some people are candidates for smaller incisions or robotic techniques. Surgeons usually aim to fix the mitral valve rather than replace it, if the damage allows. Keeping your own valve usually comes with fewer long-term risks than using an artificial one.
During surgery, the team uses different techniques to get the valve working again:
These methods fix the valve without removing it. For example, a floppy section might be removed, the flap stitched together, and a ring added for support. This keeps the valve strong and helps blood flow in the right direction.
Surgeons have excellent success rates—especially with valves leaking from degenerative disease. In the best centers, more than 90 to 99 percent of these cases are successfully repaired.
The cost of mitral valve repair depends on the hospital, surgical method, and whether robotic techniques are used. In India, the price may range from INR 3 to 7 lakhs on average.
You’ll likely remain in the hospital for several days, with full recovery typically taking about four to eight weeks. Most patients wake up breathing on their own but feel tired and sore at first. Walking and light movement start early, and your energy improves over time.
If you had a less invasive approach (like robotic surgery), recovery may be a bit faster since the cuts are smaller.
After surgery, you’ll spend a short time in the cardiac ICU, then move to a regular room. Most people get back to normal activities in one to two months, depending on their overall health and the type of surgery done. Cardiac rehab—guided exercise and education—is often part of the plan to rebuild strength.
A well-done repair can take pressure off the heart, relieve symptoms, and help you live longer and feel better than if the valve were left untreated.
In some cases, the mitral valve is so badly damaged that it can’t be fixed and needs to be replaced instead. In those cases, doctors remove the old valve and replace it with a new one. This is called mitral valve replacement.
The damaged valve is removed, and a new one is stitched into place. Replacement valves come in two types: mechanical and tissue.
These are made from materials like metal or carbon. They’re built to last—often for the rest of a person’s life. That durability is a big plus. But there’s a downside—blood can cling to the valve and form clots.
To prevent this, anyone with a mechanical valve has to take a blood thinner like warfarin for life. That helps stop clots, but it also raises the chance of bleeding—from small things like bruises to more serious risks. You’ll also need regular blood tests and need to be consistent with your diet, especially foods with vitamin K (like leafy greens).
The mitral valve replacement cost in India varies widely depending on the valve type and facility. Mechanical valve replacements may be slightly more expensive due to the lifetime of medication required, while tissue valves may involve future procedures.
These valves are made from animal tissue, typically from a pig or cow, or occasionally from donated human tissue. They work well and don’t usually require long-term blood thinners. That’s a big advantage for people who can’t take anticoagulants or have bleeding risks.
But tissue valves wear out over time. Most last around 10 to 20 years, often about 15. Younger patients may need another surgery down the line to replace the valve again.
Regardless of whether you receive a mechanical or tissue valve, the surgical procedure is generally the same. It usually requires a heart-lung bypass and a hospital stay of several days. Full recovery often takes 6 to 12 weeks, depending on the surgical method and your overall health.
After surgery, most people feel better—especially if their valve was leaking badly or blocking blood flow. A new valve means no more issues with the original one. But with any replacement, there are long-term things to manage:
Your doctor will guide you through the pros and cons, considering your age, overall health, and daily lifestyle.
If your mitral valve isn’t working properly, your doctor may recommend either repairing it or replacing it.
The main indications for mitral valve repair vs replacement include the type of valve damage, overall heart function, patient age, and likelihood of long-term durability.
The choice between repairing or replacing the mitral valve depends on what’s wrong with the valve, your overall health, and your age.
Doctors usually aim to repair the valve first, especially in people with degenerative valve disease—that’s when the valve flaps become floppy or stretched out. In these cases, a repair can fix the problem without needing a new valve. Younger patients and those in good health are strong candidates for this option.
But not every valve can be repaired. If the valve is badly scarred, heavily calcified, or damaged from old infections like rheumatic fever, it may not be fixable. Mitral stenosis—when the valve becomes tight and narrow—is often too advanced for a simple repair. The same goes for valves damaged by radiation.
Sometimes, the choice is influenced by other heart problems. For example, if you also need bypass surgery, your surgeon may decide which option is safer or more efficient during the same procedure.
No matter the situation, it’s important that the repair is done by a team that does this often. Hospitals and surgeons with a lot of experience in mitral repairs tend to have the best outcomes. If your doctor recommends replacement but you’d prefer a repair, it’s worth asking for a second opinion—especially from a high-volume valve center.
Most people feel a big difference after mitral valve surgery. Whether your valve was repaired or replaced, the goal is the same—less fatigue, easier breathing, and a better quality of life.
Recovery usually takes a few weeks. You may feel good walking around after one or two weeks, but things like lifting heavy objects or doing intense exercise should wait. Most people need four to eight weeks before they’re ready for that level of activity. Your doctor will let you know when it’s okay to start driving, return to work, or get back to physical activity. Some people join a cardiac rehab program to build strength slowly and safely.
You’ll be started on a blood thinner like warfarin before you leave the hospital. This helps prevent clots from forming around the valve. You’ll need regular blood tests for life to make sure your levels are in a safe range.
This means:
Some people also notice a clicking sound from the valve. It’s normal and many patients stop noticing it after a while.
You may not need long-term blood thinners unless there’s another reason, like atrial fibrillation. Some people take aspirin for a few months and then stop. These valves don’t last forever, so your doctor will keep an eye on how it’s working with regular heart ultrasounds. Many people go 10 to 15 years before needing another procedure. If that happens, a less invasive option like valve-in-valve replacement is sometimes possible.
After surgery, you may need antibiotics before certain dental or surgical procedures. This lowers the risk of heart infection (endocarditis). Your doctor will let you know when it’s needed.
You’ll also keep seeing a cardiologist to monitor your heart and manage other meds, like those for blood pressure.
Eating well, staying active, and avoiding smoking are still important. Many patients say they feel better than they have in years once they’ve recovered. One step at a time, your energy comes back—and with the right care, most people return to their regular routines.
If something doesn’t feel right, speak up. Your recovery is personal, and your care team is there to help you through it.
Final Thought
Choosing between mitral valve repair and replacement requires careful consideration of the patient’s condition, anatomy, and long-term needs. Both options aim to restore efficient blood flow, reduce cardiac strain, and improve overall outcomes. No two cases are alike, so the approach should be individualized.
At Heart Valve Experts, we provide evidence-based guidance and advanced surgical care tailored to each case. Dr. Ankur Phatarpekar, a senior interventional cardiologist in Mumbai, brings years of experience managing complex valve disorders. Our goal is to support every referring physician and patient with clear communication, clinical precision, and a path toward better heart health.
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