Minimal invasive surgery

[TroyH]

My mother is a healthy 73 yer old who was recently diagonosed with a flailing posterior mitral valve leaflet with 3+ MR.  Strange thing is she is totally asymptomatic. Her cath showed clean cornoaries and good EF without pul. HTN or arrythmias. Her cardiologist recommends surgery for MV repair with standard sternotomy.  Questions: 1)do you think surgery in nessary or can she be treated with medication as she has very good excercise tolerance. 2)has minimal invasive surgery evolved/matured enough as a true alternative to standard sternotomy for a MV repair. 3)I am confused about all the various minimal invasive surgeries that are available from mini-low sternotomy, mini thoracotomy, Port access, AESOP?, robotic assisted, endoscopic.  Can you please explain generally the various techniques and which one has been done most 4) Can you recommend instutions here in North Carlina that does good number of minlmal invasive cardiac mitral valve repair.  Thank you very much.

[donna227]

A related discussion, Minimal invasive surgery was started.

[donna227]

A related discussion, Dr Galloway at NYU was started.

[LynnSB]

Here is some info on the minimally invasive mitral valve technique.

see the Journal of Interventional Cardiology
Vol. 16 Issue 1 Page 93 February 2003
Percutaneous Mitral Valve Repair for Mitral Regurgitation
PETER C. BLOCK M.D


Block presented "Transcatheter Treatment of Mitral Regurgitation" at the International Academy of Cardiology 3rd World Congress on Heart Disease last summer
Peter C. Block and just last month he did the 5th procedure of this kind.. here's some info:

http://www.emory.edu/WHSC/HSNEWS/releases/oct03/nonsurg.html

hope this helps!

[LynnSB]

you wrote: Can you recommend instutions here in North Carlina that does good number of minlmal invasive cardiac mitral valve repair. Thank you very much.

That's not too far from Atlanta where Dr. Peter Block at Emory is one of the top cardiologists doing minimally invasive mitral valve repair (no opening of the chest at all) in the country. It might be worth a phone call to find out if she might qualify for the procedure.

[Cleveland Clinic]

troyh,

Timing of valve surgery in asymptomatic mitral regurgitation can sometimese be debated. One thing to consider is your mother is currently 73 and if she were to need surgery 10 years form now, she may not be as healthy to tolerate the procedure. So there is no definite right answer to this question. One thing that might help is to get a second opinion before proceeding.

Minmally invasive surgery is not an alternative in all patients. comorbidities like multiple bypass and certain mitral valve pathologies cannot be done with the minimally invasive technique. An importatant factor would be the experience of the surgeon.

There are alot of high tech techniques. The type of incision is usally dictated by the type of procedure needed. Things like robotic assistance and other techniques are not what determines the quality or safety of the procedures, instead these are determined by the surgeon you choose. Again I would research your surgeon and his/her experiece.

I'm not sure specifically about surgeons in your location. Some places to check might be emory, duke or UNC.