Minimally Invasive Mitral Valve Replacement

Published on February 05, 2026

Minimally invasive mitral valve replacement is a surgical procedure to replace a damaged mitral valve through small incisions in the chest. The mitral valve plays a crucial role in regulating blood flow between the left atrium and left ventricle of the heart. When the valve becomes severely damaged and cannot be repaired, replacement may be necessary to restore proper heart function.

Unlike traditional open-heart surgery, minimally invasive mitral valve replacement is performed using smaller incisions, specialised instruments, and advanced imaging techniques. This approach aims to reduce surgical trauma while providing effective and durable valve treatment.

What is a minimally invasive mitral valve replacement?

Minimally invasive mitral valve replacement is a type of heart surgery in which a diseased mitral valve is removed and replaced with a prosthetic valve through one or more small incisions on the side of the chest. The replacement valve may be mechanical or made from biological tissue.

The mitral valve ensures that blood flows in the correct direction through the heart. When it becomes severely narrowed or leaky and cannot be repaired, valve replacement may be required to improve symptoms and prevent complications such as heart failure.

This minimally invasive approach avoids the need for a full breastbone incision and may result in faster recovery and less postoperative discomfort compared to conventional open-heart surgery.

What conditions does minimally invasive mitral valve replacement treat?

You may require mitral valve replacement if you have severe mitral valve disease that is not suitable for repair, including:

Severe mitral valve regurgitation
When the valve does not close properly, allowing blood to leak backwards with each heartbeat.
Severe mitral valve stenosis

When the valve becomes stiff or narrowed, restricting blood flow through the heart.

These conditions can lead to symptoms such as shortness of breath, fatigue, swelling of the legs, and irregular heart rhythms if left untreated.

What is the difference between mitral valve repair and mitral valve replacement?

Mitral valve repair involves fixing the patient’s own valve and preserving its structure.
Mitral valve replacement involves removing the damaged valve and replacing it with an artificial valve.

Replacement is typically recommended when the valve damage is too extensive to allow for a durable repair.

Who is a candidate for minimally invasive mitral valve replacement?

You may be a candidate depending on several factors, including:

Severity and type of mitral valve disease
Overall heart function
Whether additional heart procedures are required
Body structure and chest anatomy
Medical history and existing health conditions

Not all patients are suitable for a minimally invasive approach. Your cardiac team will perform detailed assessments to determine the safest and most effective surgical option.

What happens before minimally invasive mitral valve replacement?

Before surgery, your care team will conduct a thorough evaluation, which may include:

Echocardiogram to assess valve structure and heart function
CT scan to evaluate chest anatomy and surgical access
Cardiac catheterisation to assess coronary arteries
Blood tests and preoperative assessments

You will receive specific instructions regarding medications, fasting, and preparation before surgery.

What happens during minimally invasive mitral valve replacement?

During the procedure, your cardiac surgeon will:

Make one or more small incisions between the ribs
Use specialised instruments and a camera to access the heart
Remove the diseased mitral valve
Implant the replacement valve
Test valve function before closing the incisions

The procedure is performed under general anaesthesia and uses heart-lung bypass support.

How long does the surgery take?

Minimally invasive mitral valve replacement typically takes three to five hours, depending on the complexity of the condition and surgical approach.

What happens after surgery?

After surgery:

You will spend one to two days in the intensive care unit (ICU)
Temporary chest drains may be used to prevent fluid buildup
You will be encouraged to sit up and walk within a day or two
Breathing exercises will help reduce lung congestion

Most patients stay in the hospital for five to seven days before being discharged home.

What are the benefits of minimally invasive mitral valve replacement?

Compared to traditional open-heart surgery, benefits may include:

Smaller incisions and less scarring
Reduced pain and blood loss
Lower risk of infection
Shorter hospital stay
Faster recovery and return to daily activities

Recovery varies from person to person. Most patients experience gradual improvement in symptoms such as breathlessness and fatigue over several weeks.

You may be advised to:

Avoid heavy lifting for several weeks
Attend follow-up appointments
Take prescribed medications consistently

Cardiac rehabilitation programmes are often recommended to help improve strength, endurance, and heart health safely.

Additional Common Questions

Can the mitral valve be replaced without open-heart surgery?

Yes. In selected patients, the mitral valve can be replaced using minimally invasive surgical techniques. The suitability of this approach depends on the individual’s heart condition, anatomy, and overall health.

In some cases, catheter-based therapies may also be considered, depending on the type of valve disease and patient suitability.

Minimally invasive mitral valve replacement is an advanced surgical option for patients with severe mitral valve disease that cannot be repaired. By using smaller incisions and specialised techniques, this approach offers effective treatment with potential benefits of faster recovery and reduced surgical trauma.

Early evaluation and appropriate treatment can significantly improve heart function, symptoms, and quality of life.