Surgeon Q&A: What is the Latest Research on Less Invasive Aortic Valve Surgery?

Eileen Chen, who is a member of our Facebook community, recently asked me, “Hi Adam, What is the latest research on less invasive aortic valve surgery?”

To answer Eileen’s question, I was very lucky to interview Dr. Allan Stewart during the Heart Valve Summit conference. So you know, Dr. Stewart is an excellent surgeon (and super nice guy) who has successfully treated over 100 patients from our community — including Christine Pittelli, Bill Easton, William Brogna and many others. 🙂

Here’s how Dr. Stewart answered Eileen’s question…

I hope this video helped Eileen (and perhaps you) learn more about less invasive aortic valve surgery techniques. I want to thank Eileen for her question. I also want to extend a humongous thanks to Dr. Allan Stewart for his continued support of our patient community.

Keep on tickin!

P.S. For the hearing impaired members of our community, I have provided a written transcript of this interview below.

Adam: Hi, everybody! It’s Adam with I’m here at the Heart Valve Summit in Chicago, Illinois, and I am thrilled to be with Dr. Allan Stewart who is a Heart Surgeon at Mount Sinai Hospital in New York. Dr. Stewart, thanks for being with us.

Dr. Stewart:  My pleasure, Adam. Good to see you.

Adam:  We are answering your questions that you submitted at our Facebook page. We’re going to answer a question, Dr. Stewart, from Eileen Chan. She says, “I’m looking into learning about any new research on less invasive aortic valve surgery.” Can you share about what you’re doing in the hospital these days?

Dr. Stewart:  Absolutely, Adam! As we really evolve with new technology and new techniques, there’s a spectrum of less invasive surgery. It’s not necessary anymore to make a foot-long cut down the center of the breastbone and open it up; the incision you had many years ago. We’ve evolved now, and we have better techniques and better technology.

A standard aortic open heart surgery is still done with a chest incision, but the chest incision is only about five centimeters, about two and a half, three inches long. Now there are two options for that. One option is right through the breastbone at the top, where we make an upside down ‘T’, but the skin incision is very tiny and we put it together with titanium plates. That way you can get back to function very, very quickly in life, and you won’t alarm in the airport.

The other option is to go right through the side of the chest. Now, this is not a cosmetically appealing option to a woman because it’s right into the breast tissue. For a woman such as Eileen, I would favor the tiny incision down low. She can still wear the plunging neck gowns and the scar won’t show.

Now, I don’t know Eileen’s age but the other options available for less invasive surgery is TAVR, which we have a very robust program at Mount Sinai.

Adam:  Dr. Stewart, for people who don’t know what TAVR means, can you explain that what technology is?

Dr. Stewart: TAVR is obviously an acronym. TAVR means trans-aortic valve replacement — transcatheter. What transcatheter means is that the valve is not implanted with open-heart surgery; the valve is implanted through a neostick in the groin. Patients are normally away; they’re not even asleep for it anymore. It takes about two hours to do and the patients are home usually in two or three days. That’s how you and I will have our heart valves replaced in 20 years, but it’s something that’s reserved for elderly people right now and patients who are at high to intermediate risk for surgery.

As time goes on and more information is given to us, we’re now backing that risk profile down so that that’s going to be the standard of care soon for everyone.

Adam: Well, Dr. Stewart, as always, thanks for your support of this community, all the educational support, of course the care that you’re giving to all the great people out there. Thanks for what you do!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of

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