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Re: minimally invasive valve replacement

Posted By CCF CARDIO MD - DLB on June 01, 1998 at 09:22:29:

In Reply to: minimally invasive valve replacement posted by leesa on May 31, 1998 at 21:24:27:

hi. i have moderate aortic insufficiency and am interested in some information on minimally invasive valve replacement. when is the best time to have this type of surgery done? is it generally too late once surgery is "necessary"? does one not need to be put on heart/lung machine with this type of surgery? what is the difference between this type of surgery and the conventional "open heart"? thank you very much for your time given.
Dear Leesa:
Minimally invasive surgery for the aortic valve involves a smaller incision than standard surgery.  To be done safely, a heart-lung machine must be used.  The minimally invasive approach is not suitable for patients that require repeat open heart surgery or that require bypass grafting or other valvular surgery at the same time.   There appears to be less post-operative pain and bleeding with the minimally invasive approach, though it is, at present, unknown if there is any long-term benefit compared to standard surgery.  The aortic valve can be either repaired or replaced through a minimally invasive approach.  The development of minimally invasive aortic valve surgery does not change the timing of surgery (that is, dont do it earlier just because of the "less invasive" approach).
The timing of surgery is a difficult issue.  The best time to perform the surgery is before the left ventricle, the hearts main pumping chamber, starts to decompensate.   The best way to determine this is with echocardiography (cardiac ultrasound).  If the left ventricle is getting enlarged or weak, it is an indication to proceed with surgery.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist who specializes in echocardiography at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.

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