Keyhole Mitral Valve Replacement Surgery

At The Keyhole Heart Clinic, we provide mitral valve replacements designed to reduce pain, minimise recovery time, and help you get back to living fully. Our clinical lead, Mr Inder Birdi, is a pioneer in minimally invasive heart valve replacement surgery with over 20 years of experience.

2 Weeks

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minimally invasive procedures

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35 Years

of clinical and surgical experience

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+44 20 8079 7860

KEYHOLE SURGERY

HEART CONDITIONS

Keyhole Mitral Valve Replacement Procedure

If you’ve been told you need mitral valve replacement, you might be picturing open-heart surgery with its lengthy recovery and prominent scarring. But there is a different, more innovative path forward.

What sets us apart is our commitment to cutting-edge surgical technology and compassionate, patient-centred care. Mr Inder Birdi pioneered minimally invasive surgery techniques for mitral valve surgery that prioritise your heart’s health and quality of life.

Explore our resources and discover how minimally invasive procedures for mitral valve problems can benefit your life with reduced impact.

What Is the Mitral Valve & Why Does It Matter?

The mitral valve plays an important role in keeping blood flowing efficiently through your heart. Located between the left atrium and ventricle, it opens and closes with each heartbeat to pump blood from the lungs to the body.

A damaged mitral valve can cause blood to leak backwards or struggle to flow through. This disrupts circulation, puts stress on the heart, and can lead to heart disease and other serious effects.

Left untreated, severe mitral valve disease may affect general health, including kidney failure, and can reduce life expectancy. Treating the problem early helps improve blood flow, limits long-term complications, and supports a more active, balanced life.

The valve’s two leaflets are supported by fine cords called chordae, which anchor them to the heart muscle and allow smooth, coordinated movement. When these structures fail, symptoms may worsen, sometimes requiring medication such as pain medicine while definitive treatment is planned.

When Mitral Heart Valve Surgery is Necessary

Mitral heart valve surgery is needed when the mitral valve fails to function correctly. Surgery can involve a minimally invasive mitral valve replacement.

Common conditions requiring mitral valve surgery include:

1. Mitral Valve Regurgitation

This condition occurs when the valve fails to close fully, allowing blood to flow backwards into the left atrium. Over time, mitral regurgitation causes the heart chambers to stretch, leading to diminished heart function and irregular heart rates. Surgery is usually recommended if the leakage is severe or symptoms develop.

2. Mitral Valve Stenosis

This is when the valve opening is narrowed, limiting blood flow into the left ventricle. Mitral stenosis raises pressure in the heart and lungs, causing shortness of breath and fatigue. Surgery is needed for severe cases that don’t improve with medicine.

3. Infective Endocarditis

An infection can damage the mitral valve, leading to leakage or sudden failure. Surgery is often urgent to remove infected tissue and fix or replace the valve.

4. Severe Mitral Valve Prolapse

If the valve leaflets bulge into the left atrium and cause significant leakage that medicine cannot control, surgery is advised to prevent heart failure and other complications.

Types of Replacement Valves

There are 2 different types of alternative valves:

1. Tissue Valve

These biological valves are manufactured from human or animal tissue, such as pig or cow tissue.

Pros: Usually, there is no need for long-term thinners like warfarin unless you already need them for another reason (e.g, atrial fibrillation).
Cons: Animal and human heart tissue tend to wear out more quickly, especially in the mitral position. They may need to be replaced with new valves in the future.

2. Mechanical Valve

This is an artificial valve.

Pros: Designed to last a lifetime.
Cons: Requires taking warfarin (a blood thinner) for life, which means regular blood tests and managing bleeding risk.

Choosing the Right Valve Based on Age and Life Stage

Your age plays a significant role in determining the type of valve that is best suited for your mitral heart valve replacement surgery.

Under 50: A mechanical valve is strongly recommended; you’re likely to outlive a biological valve and would otherwise need more mitral valve surgeries.
50 to 70: Often still a mechanical valve for long-term durability, unless there are other considerations.
Over 70: A tissue valve is usually the better option. It avoids the risks associated with warfarin, which can become more severe with age.
Women under 50 considering pregnancy: If you’re planning to have children, warfarin (required with mechanical valves) can harm a developing baby during the first trimester. In these cases, we may recommend a tissue valve instead. If a mechanical valve is still the best option, you’ll need to switch to injectable thinners during pregnancy for safety.

Risks of Mitral Valve Replacement Surgery

Mitral valve replacement is a well-established and effective treatment when repair is not possible. However, as with all major heart surgeries, it carries risks compared with mitral valve repair.

The possible risks of a mitral valve replacement include:

Higher surgical risk than valve repair

Mitral valve replacement carries a greater operative risk than repairing the natural valve.

Lifelong blood-thinning medication (mechanical valves)

Mechanical valves require long-term anticoagulation (such as warfarin), which increases the risk of bleeding and requires ongoing monitoring.

Limited durability of tissue valves

Tissue (animal) valves can wear out over time and may require further surgery in the future.

Increased risk of long-term complications

Replacement does not preserve the natural valve structure, which can affect long-term heart function compared with repair.

When replacement is necessary, careful assessment and modern surgical techniques help minimise these risks and achieve excellent outcomes.

Your Suitability for Minimally Invasive Mitral Valve Replacement

To assess your suitability for keyhole heart valve surgery, we begin by reviewing your medical history and essential tests:

Echocardiogram
Electrocardiogram (ECG)
Coronary angiogram

Many patients who come to us have already undergone these tests, and we usually need to obtain the images for review.

You will also need a CT scan to check:

The health of your aorta (your body’s main blood vessel)
Whether we can safely use micro-pipes in the groin to connect you to the heart-lung machine during surgery

This test only takes a few minutes and provides valuable insights into your overall health as well.

Once we have decided that you are suitable for keyhole mitral valve surgery, we will plan the surgery to occur as soon as possible, and certainly within 2 weeks of your assessment.

How Is Keyhole Surgery for Mitral Valve Replacement Performed?

Keyhole mitral valve replacement is minimally invasive and presents fewer risks than open-heart surgery. It is performed through a small incision over the right side of the chest between the ribs and does not require cutting any bone.

When the mitral valve is calcified, it is better to replace the mitral valve with a tissue valve (pig or cow) or a metal valve.

The wound recovers within seven to 10 days and is cosmetically very appealing. This is the preferred technique for mitral valve repair keyhole surgery at The Keyhole Heart Clinic, and our preferred location is The London Clinic.

We do not use robotic arms, like the Da Vinci Robot, since we have become highly skilled in the use of specially designed surgical instruments to perform the surgery with extreme accuracy.

Using these instruments and a 4K television monitor, we can achieve positive results very quickly. The time spent on the heart-lung bypass machine, if at all, is significantly shorter than with robotic surgery. We believe that this leads to a far superior recovery due to the lower risk of heart-lung bypass-related dysfunction.

We also avoid spreading the ribs apart, which means that the pain associated with surgery is minimal.

Patients who undergo this surgery experience:

Less pain
Shorter hospital stay
Less risk of wound infection
Healing in days rather than months
Smaller scars
Quicker recovery

Recovery Time From Keyhole Mitral Valve Replacement

Most patients spend 4 to 7 days in the hospital after a keyhole mitral valve replacement procedure. They are generally walking unaided by the time they go home.

After keyhole mitral valve surgery:

Expect some fatigue for 1 to 2 weeks
Most normal daily activities can resume early
By week 3, many can walk at least 1.5 kilometres a day
Light exercise is usually fine from week 4

You’ll have follow-up appointments with your surgeon and care team, during which your medications may be adjusted and vital signs taken. Cardiac rehab can help speed up recovery and support a safe return to a healthy lifestyle.

If you’ve had open heart surgery through the breastbone, recovery will take longer. You’ll need to avoid heavy activity for at least 12 weeks to allow proper healing.

Watch Mr Birdi’s informative video series on your mitral valve treatment options, where he explains the pros and cons of repairing versus replacing the mitral valve.

FAQs About Surgical Mitral Valve Replacement

These are the questions we hear daily regarding mitral valve surgery.

Can I delay my procedure for mitral valve replacement?

No, once you have developed severe mitral valve problems, like a leaky valve or poorly opening valve due to calcification or mitral stenosis, certain risks must be avoided to ensure a long and healthy life.

One of the most important and avoidable complications of mitral heart valve disease is an irregular heartbeat called atrial fibrillation. Once this develops, it reduces heart function by up to 30%, creating blood clot-related stroke risks. This latter issue means that you will be forced to take a blood thinner like warfarin (or drugs called NOACs) for the rest of your life.

The other serious complication associated with mitral valve disease is high blood pressure in the lungs (commonly referred to as pulmonary hypertension). These two complications can be avoided by early surgical intervention.

Mr Inder Birdi says:

“Patients with mitral valve disease are often referred for surgical intervention too late in their disease pathway for them to receive the greatest benefit that surgery offers. I would like to see patients before they develop atrial fibrillation or high blood pressure, even if they have no symptoms.”

What is the cost of mitral valve replacement in the UK?

The cost of private mitral valve replacement in the UK is about £35,000. This includes a 7-day stay in hospital (including the intensive care unit), your surgeon’s and anaesthetist’s fees, and the technology used to perform your surgery.

The many benefits of private treatment relate to both the speed with which you can have your surgery, as well as the advantage of allowing you to choose your healthcare team. Learn more about the stages of undergoing heart surgery with us.

Keyhole Heart Clinic: World-Class Heart Valve Replacement

Modern solutions for heart conditions are now accessible through The Keyhole Heart Clinic. Our clinic is led by Mr Inderpaul Birdi, a renowned heart surgeon and consultant with over two decades of experience helping patients through complex heart procedures.

Mr Birdi specialises in keyhole cardiac procedures, which use smaller incisions than traditional surgery. These include:

Keyhole coronary bypass surgery (from single to quadruple bypass)
Keyhole tricuspid valve replacement
Keyhole aortic valve replacement
Keyhole atrial fibrillation ablation
Keyhole atrial septal defect closure

The clinic also provides heart screening services.

Mr Birdi is among a small group of surgeons worldwide with the expertise to perform keyhole coronary bypass surgery and keyhole aortic valve repair. In 2022, he performed the UK’s first successful quadruple heart bypass using keyhole methods.

Book an appointment to discuss your minimally invasive mitral valve replacement options. Use one of the links on this page or call us on +44(0)20 4527 3456.

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