Mitral valve repair or replacement

  My 33 year old niece is going to have to submit to mitral valve surgery soon.  She had open heart surgery 10 years ago to repair a hole in her heart there since birth.  She was told 7 years ago that she had a leaky valve.   Recently she has been experiencing tightness in her chest.  Following an echo it was established that she woud need open heart surgery.  She must have futher testing to see if she will have a replacement or repair.  The questuiin she has is if she has a replacement will she have to be on anti rejection drug for the rest of her life and will she need to have cardiac rehab and if so for how long?
  Marlene

[CCF CARDIO MD APS]

Dear Marlene,
There is no valvular surgery that requires anti-rejection medications, as a matter of fact the only open
heart surgery that does require anti-rejection medications is heart transplant.
Now there are two major categories of valve replacements:
1)bioprosthetic valves-made of tissue from a pigs heart or a human cadaver. These
tend not to be used in young patients because they do not usually last more than 10 years on average.
The advantage of this type of valve is that it requires no blood thinner (see below).
2)mechanical prosthetic valve-this is made of man-make materials that
have a tendency to cause clots to form when placed in the patients heart- thus
every patient receiving this artificial valve will be on coumadin (a blood thinner) for life.
The advantage of this valve is that it can last a very long time, if not forever.
*note that in both cases, regardless of the type of valve put in the patient will
have to take antibiotic prophylaxis for certain procedures like going to the dentist.
Everyone that has open heart surgery needs some form of cardiac rehabilitation in those first
few weeks (it generally takes 4-6weeks to recover from open heart surgery).  The physical therapists
here at the Cleveland Clinic start working with patients on the second day out of surgery and many of them
start rehabilitation in the hospital and go home with their own individualized plan for continued recovery which includes
most importantly daily exercise.
I hope that this information has been helpful, please feel free to write with any further question you might have.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and
treatment can only be made by your physician(s).