What Is Mitral Valve Repair?

If you've been told your mitral valve is leaking, the word "repair" is usually the hopeful one in the conversation. Instead of taking the valve out and putting in a new one, the surgeon fixes the valve you already have — tightening it, reshaping it, or mending the cords that hold it — so it closes properly again. The video at the top of this page, "Mitral Valve Repair" (about five minutes), shows a repair operation itself, so you can see the surgical setting and the careful work on the valve before you read on. This guide walks you through what to expect, from why a valve starts leaking to what recovery usually feels like.

Why a mitral valve starts to leak

The mitral valve sits between the two chambers on the left side of your heart. Its two flaps, called leaflets, open to let blood flow forward and then close tightly so none slips backwards. A leak — mitral regurgitation — happens when those leaflets no longer meet cleanly. Sometimes a leaflet bulges or flops backwards (prolapse), sometimes the supporting cords stretch or snap, and sometimes the ring around the valve widens so the leaflets are pulled apart. Rheumatic fever, still common in many parts of the world, can also scar and distort the valve over time. The second video on this page, Rheumatic Mitral Valve Repair (about sixteen minutes), looks at repair in exactly that rheumatic setting. However it starts, a significant leak makes the heart work harder, and over time that strain can lead towards the symptoms described in our guide to heart failure.

Repair or replace? The decision you'll hear discussed

Surgeons generally prefer repair when the valve's tissue is healthy enough to work with, because keeping your own valve avoids some of the long-term trade-offs of a replacement. Whether repair is realistic depends on what imaging shows about the leaflets, cords and ring — which is why an ultrasound scan of the heart is central to planning, as our article on what an echocardiogram shows explains. If a valve is too damaged to fix reliably, replacement becomes the safer option instead; our guide to heart valve replacement  covers that path, including how it differs from the catheter-based approach in our TAVR article.

What happens on the day

You'll be under a general anaesthetic, so you won't feel or remember the operation. Most repairs are done through an opening in the breastbone, though some centres use smaller incisions between the ribs, sometimes with robotic assistance. Because the heart has to be still while the valve is being fixed, a heart-lung machine usually does the heart's job for that part of the operation. Working on the valve itself, the surgeon might trim a prolapsing section of leaflet, replace broken cords with fine artificial ones, sew a supportive ring around the valve's base to restore its shape, or combine several of those steps. Before you wake up, the team checks the repair — often with an ultrasound probe — to confirm the valve is closing well. You'll typically wake in an intensive care or high-dependency unit with monitors attached and a breathing tube that's removed once you're awake and breathing comfortably.

The first weeks afterwards

Expect several days in hospital. The early pattern is familiar to most heart-surgery patients: a sore chest, tiredness that feels out of proportion to what you've done, and daily encouragement to sit up, walk the ward and do breathing exercises. By the time you go home, most people are managing stairs slowly and short walks. Full recovery is measured in weeks rather than days — the breastbone, if it was opened, needs time to knit, and you'll be given guidance on lifting and driving. Follow-up usually includes another echocardiogram to check how the repaired valve is performing, and many people are invited to cardiac rehabilitation. If anything feels off — increasing breathlessness, palpitations, fever, or wound redness — your team will want to hear about it promptly rather than at the next routine visit.

References & further reading

• MedlinePlus — Heart Valve Diseases:  https://medlineplus.gov/heartvalvediseases.html
• MedlinePlus — Mitral Valve Surgery, Minimally Invasive (Medical Encyclopedia): https://medlineplus.gov/ency/article/007411.htm 
• NHLBI — Heart Valve Diseases: https://www.nhlbi.nih.gov/health/heart-valve-diseases 

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Is repair always better than replacement?

Not always. Repair is usually preferred when the valve can be fixed durably, because it preserves your own tissue. A valve that is heavily scarred, infected or badly damaged may be safer to replace. Your surgeon decides from your imaging which is likely to last better for you.

How long does the operation take?

Valve operations generally take several hours, including anaesthesia, preparation and the time on the heart-lung machine. Your team can give you a closer estimate for your own case, and your family will usually be updated during the day.

Will I need blood thinners for life after a repair?

That depends on the repair, your heart rhythm and other factors. Some people take a blood thinner for a limited period after surgery, and some need one long term for other reasons such as atrial fibrillation. Your own prescription is set by your team — don't start or stop based on general reading.

Can a repaired valve leak again?

A good repair is designed to last, and follow-up scans check on it over time. A small number of repairs do develop a leak again years later, which is one reason ongoing follow-up matters even when you feel completely well.

When can I get back to normal activities?

Light activity and walking start in hospital. Driving, heavier lifting and a return to work typically wait several weeks and depend on how your surgery was done and how you're healing. Your discharge paperwork and follow-up team will set out your personal timeline.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/13/26

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. If you have chest pain, severe breathlessness, or faintness, seek urgent medical care.