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- Wed Feb 19, 2003 9:25 am
This is in response to your reply to my last e-mail. My cardiologist told me that the mitral valve needs to be repaired and can be done through "minimally-invasive valve surgery. Do you know anything about this procedure. Where is the incision made...what side, between which ribs? I was told that the surgeon will decide what to do with the aortic valve when he is "inside". My question is can he see the aortic valve using the minimally invasive technique or must the chest be cracked open? I'm am not interested in the minimally-invasive technique, only the technique which will be the most effective.
| Dr. Yasser Mokhtar
- Wed Feb 19, 2003 9:59 pm
Thank you very much for using our website and thank you for the update.
Minimally invasive cardiac surgery is a new technique develloped in cardiac surgery like coronary artery bypass and valve repair and replacement. It requires certain expertise on the side of the surgery-anesthesia team. It is not widespread and not every body is familiar with it.
As the name implies the incision done is smaller. Surgical technique is somewhat different and there are more technological tools used to aid the team during surgery.
Visualization of the mitral and aortic valves is adequate but limited and surgery is more technically demanding.
It has certain advantages and has its disadvantages as well.
1. Patient being taken off the breathing machine earlier.
2. Less blood loss.
3. Less postoperative pain.
4. Lower incidence of pericardial effusion.
5. Lower incidence of abnormal cardiac rhythms.
6. More complete and rapid recuperation.
7. Decreased risk of sternal infection and instability.
8. Fewer postoperative lung complications.
9. Superior cosmetic result.
10. Shorter length of hospitalization.
In cases of aortic valve surgery using minimally invasive technique, comparison done between conventional and minimally invasive technique was encouraging. On the other hand, in cases of mitral valve surgery, comparison has been more controversial (meaning that it did not offer much benefit and may be same rate of complication and it is more difficult technically).
If your doctor wants to wait and there is no pulmonary hypertension as you mentionned, then i guess you should be started on medications (unless you are already on them) that will help with your symptoms, make you feel better and improve you heart function as well. In addition, you have to be under good supervision and follow-up.
Regarding replacing the two valves in the same time or repairing one and replacing the other in the same procedure, or doing each procedure separately, i guess this goes back to the surgeon and whether he is comfortable doing both procedures in the same time or he would like to do each on separate occasions.
Once mroe, thank you very much for using our website http://doctorslounge.com and i hope that this information helped and keep me posted.
Yasser Mokhtar, M.D.
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