Mitral Valve Repair (Open chest or minimally invasive?)

[fyshy]

I am 52, male, in very good health. I was diagnosed with severe mitral regurgitation this past week. I have had the TEE, and a CT scheduled this week along with a meeting with heart surgeon. Our local surgeons only repair mitral valves with open chest technique. I am interested in the minimally invasive option since I have no other health issues. Is there any reason I should consider the open chest surgery? Seems like the obvious best choice is minimally invasive. Thanks.

[kenkeith]

Thanks for response. You are correct there are two minimally Invasive mitral valve procedures and you may be a very good candidate for the procedure. I have coronary vessel occlusions, etc. and that procedure may be an option for me.

The Mayo Clinic and Cleveland Clinic surgeons are pioneers in the development of minimally invasive techniques for mitral valve repair, Cleveland Clinic goes on to say . "today, nearly all mitral valve repairs can be performed through a 2-3 inch incision on the right side of the chest. This approach may also include the use of a surgical robot, which allows an even smaller incision.

A second minimally invasive approach through the center of the chest is available for selected patients whose anatomy is best addressed through this incision. Minimally invasive approaches may also be used for patients who require aortic valve or tricuspid valve surgery, alone or in combination with mitral valve surgery. In addition, Cleveland Clinic is a leader in research into percutaneous (through the skin) approaches to mitral valve repair, which may lead to additional treatment options in the future.

Take care and I wish you well going forward.  I don't see a downside to go with minimum invasion therapy for valve repair except it requires the special skill of surgeons with a good record of successful operations.  Generally, to evaluate a good surgeon is to select one that has a record of at least 1000 successful operations.

Ken

[fyshy]

I am still learning about the options. Your post was very helpful. The "minimally invasive" surgery I am referring to is the technique that enters from the right side of the chest. I am not as concerned about the cosmetic issue of a smaller scar as I am about having my chest opened up. I have no coronary blockages. I have a meeting with a surgeon this week and I am sure I will learn more about my condition and options.
Thank you for your help and good luck to you.

Neal

[kenkeith]

I have moderate to severe MVR for more than 7 years and I am in a watch category. By minimal option are you referring to samll incision (sternotomy)?  Is your MVR caused by leaflet mobility (prolapse) or an abnormal annulus.

"The advantage of a small incision is mainly cosmetic (the scars are smaller and less visible). In some patients, the pain after surgery may be reduced and recovery from surgery is faster when surgery is done through a smaller incision. Operating through small incisions is however more technically demanding and in some cases could reduce the safety of the procedure.

The term “minimally invasive surgery” covers a spectrum of approaches. The goal is to perform surgery through a smaller incision without compromising the safety and long-term results of conventional mitral valve repair".  

Hope this helps, and if you have any further questions or comments you are welcome to respond.  Take care,

Ken