Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
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Heart Surgery
Mitral valve replacement
What mitral valve replacement is, when the valve is removed rather than repaired, how mechanical and tissue valves differ and what each means for blood thinners, the operation step by step, approximate costs in Turkey against the UK, US and Germany, hospital stay, recovery, risks and how to check a cardiac team.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
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Mitral valve replacement in Turkey: what it is and when it is needed
Mitral valve replacement is open-heart surgery in which a diseased mitral valve is removed and an artificial valve is stitched into its place. The mitral valve controls blood flow from the left atrium into the left ventricle. It can fail by leaking (regurgitation) or by narrowing so that blood cannot pass freely (stenosis). Replacement is chosen when the valve is too scarred, calcified or damaged to be repaired, which is common after rheumatic fever, in advanced calcific disease and after infection of the valve. Cardiac surgery units in Turkey perform the operation routinely, either through a full sternotomy or, in selected cases, a smaller right-sided incision.
This guide explains how replacement differs from repair, which type of valve you may be offered, how the operation and recovery go, what it costs against the UK, US and Germany, and how to check a team. It does not replace the advice of your own cardiologist; all planning starts from your echocardiogram and reports. For other heart procedures see cardiology treatments in Turkey.
Why replace the mitral valve instead of repairing it?
When repair is possible it is usually preferred, because the patient's own valve is kept; see our guide to mitral valve repair. Replacement is the sound choice, not a lesser one, when the anatomy does not allow a durable repair. Typical reasons are severe mitral stenosis with a stiff, calcified valve, rheumatic damage to the leaflets and cords, a valve destroyed by endocarditis, a previous repair that has failed, and leaks from a stretched valve ring that cannot be reconstructed. Often the surgeon plans for repair and replaces the valve only if the repair does not hold on the test during surgery. Where possible, the supporting cords are preserved during replacement because this helps the left ventricle keep its shape and function.
Mechanical or tissue valve: which one is used for the mitral position?
The valve choice is the most important decision in the plan, and it should be discussed with you in detail. A mechanical valve is made of carbon and metal alloy; it is very durable but needs lifelong warfarin treatment with regular INR blood tests, because clots form on it otherwise. A tissue (bioprosthetic) valve is made from animal heart tissue mounted on a frame; it does not usually need long-term warfarin after the first months, but it wears out over time and may need replacing, with the lifespan shorter in younger patients.
| Valve type | Suited to | Typical limits |
|---|---|---|
| Mechanical | Younger patients who can manage warfarin and want to avoid reoperation | Lifelong anticoagulant; bleeding risk; not suited to some pregnancies |
| Tissue (bioprosthetic) | Older patients, and those who cannot take warfarin | Degenerates over years; may need replacement |
The choice depends on age, other illnesses, rhythm (atrial fibrillation often needs anticoagulation anyway), pregnancy plans and your ability to have regular blood tests at home, so ask your own cardiologist for an opinion too. Consider the follow-up burden before travelling: warfarin monitoring continues for life with a mechanical valve.
How is mitral valve replacement performed, step by step?
The operation is done under general anaesthesia and usually lasts three to five hours. The chest is opened through the breastbone (or a small right-sided incision), the circulation is taken over by a heart-lung machine and the heart is stopped. The surgeon opens the left atrium, removes the diseased leaflets, usually leaving part of the supporting apparatus in place, and sews the new valve into the valve ring with a ring of stitches. The atrium is closed, the heart is restarted, and an echo probe in the oesophagus checks that the new valve opens fully and does not leak. Temporary drains and pacing wires are placed, and you wake up in intensive care.
Mitral valve replacement cost in Turkey compared with the UK, US and Germany
The ranges below are approximate figures for a private operation including the hospital stay, not hospital quotes. The hospital confirms its own price in writing once it has seen your reports.
| Country | Approximate cost range |
|---|---|
| Turkey | €13,000 – €30,000 |
| United Kingdom | €32,000 – €65,000 |
| United States | €75,000 – €160,000 |
| Germany | €27,000 – €60,000 |
The price depends on the valve (a mechanical valve and a tissue valve are priced differently), whether a second procedure such as bypass grafts, tricuspid repair or a rhythm procedure is done at the same time, the approach, intensive-care time and any complication that lengthens the stay. A package normally includes pre-operative tests, surgery, the valve, anaesthesia, intensive care, ward nights, medication and transfers. Ask what is excluded and how a longer admission is charged.
Does mitral valve replacement work, and how long does a valve last?
For people whose valve cannot be repaired, replacement relieves breathlessness and protects the heart from further strain in most cases, and it is a well-established operation with decades of follow-up. Mechanical valves are designed to last a lifetime, but the need for anticoagulation brings a lifelong risk of bleeding and of clots if tablets are missed. Tissue valves in the mitral position generally last around ten to fifteen years, and sometimes longer in older patients, so a second operation or a catheter valve-in-valve procedure may be needed later. Long-term results depend on the heart muscle before surgery, which is why surgeons advise acting before the ventricle weakens.
Who is a good candidate for mitral valve replacement, and who is not?
Candidates are people with severe symptomatic mitral stenosis or regurgitation, or with signs on echo that the heart is enlarging or weakening, where repair is unlikely to succeed. The surgeon also considers age, other valves, coronary arteries, lung and kidney function and frailty. Higher-risk situations include active infection, a very weak heart, advanced lung disease and recent stroke, and in these cases a thorough local assessment comes before any thought of travel. If you have severe symptoms at rest, chest pain or fainting, seek urgent care locally. Some patients with narrowed coronary arteries need coronary stenting or bypass as well, and those with a diseased aortic valve may need replacement of the aortic valve in the same operation.
What is recovery after mitral valve replacement like?
Expect one to two days in intensive care and about five to seven further days on the ward. After a sternotomy the breastbone takes six to eight weeks to heal, during which you do not lift heavy objects or drive. If you have a mechanical valve, the dose of warfarin is adjusted in hospital and for several weeks afterwards, and the INR is checked often until it is stable.
| When | What to expect |
|---|---|
| Days 1-2 | Intensive care, breathing support removed, drains out |
| Days 3-8 | Ward, walking, wound care, echo and blood tests, anticoagulant dosing |
| Weeks 2-6 | Rest at home, short walks, no lifting; flying only if cleared |
| Weeks 6-12 | Breastbone healed, return to work and driving step by step |
| 3-6 months | Energy returns; echo review and cardiac rehabilitation |
For a trip, plan roughly twelve to fourteen days in Turkey, because the surgeon should check your wound, rhythm and INR before you fly, and longer if there are complications.
What are the risks of mitral valve replacement?
This is major surgery and the risks are real. They include bleeding, infection of the wound or the new valve (endocarditis), irregular heart rhythm, stroke, kidney problems, a valve leak around the edge or valve failure, and, rarely, death. Mechanical valves add the risk of clots and bleeding linked to warfarin. The NHS and the British Heart Foundation both note that risk rises with age, other illnesses and emergency operations. Ask the unit for its own mitral surgery results and what the plan is for a complication.
How do I choose a cardiac team, and what are the red flags?
The hospital should have a cardiovascular surgery department, a cardiac intensive-care unit with round-the-clock cover, perfusionists, transoesophageal echo and a plan for anticoagulation follow-up with your own doctor. The surgeon should be a registered cardiovascular surgeon who does valve surgery regularly. Red flags: a price quoted without your echo report, a valve type recommended without discussion, promises of a risk-free result, pressure to book quickly and no plan for aftercare at home. See how our process works and request a plan through the free quote page.
Questions to ask the clinic:
- Is repair possible for me, and what happens if it is not?
- Which valve do you recommend, and why, for my age and lifestyle?
- How many mitral operations does the surgeon do each year?
- Who adjusts my warfarin and checks my INR after I fly home?
- What does the package cover if I need a longer stay?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is open-heart surgery in which a diseased mitral valve is removed and an artificial valve, mechanical or tissue, is stitched into its place. It is used when the valve is too damaged to repair.
Approximate ranges are €13,000 to €30,000 in Turkey, against about €32,000 to €65,000 in the UK. The price depends on the valve, extra procedures and the length of stay; the hospital confirms it in a written quote.
A mechanical valve lasts longer but needs lifelong warfarin. A tissue valve avoids long-term warfarin but wears out over time. The choice depends on age, rhythm, pregnancy plans and your cardiologist's advice.
Mechanical valves are designed to last a lifetime. Tissue valves in the mitral position generally last around ten to fifteen years, sometimes longer in older patients, so a later reoperation may be needed.
Expect about a week or more in hospital, six to eight weeks for the breastbone to heal and gradual return to work over two to three months. Cardiac rehabilitation is usually advised.
Repair is generally preferred when it is possible because your own valve is kept. Replacement is chosen when the valve is too damaged to repair, and it is the appropriate option in those cases.
Mechanical valves require lifelong warfarin with regular INR checks. Tissue valves usually need anticoagulants for the first few months only, unless another condition such as atrial fibrillation requires them.
Risks include bleeding, infection, stroke, irregular rhythm, kidney problems, valve leakage and, rarely, death. Risk is higher with age, a weak heart, other illnesses and emergency surgery.
You are asleep during surgery. Afterwards the chest wound is sore and pain is controlled with medication, which most people find manageable within a couple of weeks. Walking begins on the first or second day.
Plan about twelve to fourteen days: around a week in hospital plus time for checks of the wound, rhythm and INR before flying. Complications can extend the stay.
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