My wife, 66 years old, is facing mitral valve repair surgery. We are getting differing opinions on whether to have the minimally invasive or sternotomy. ...Read more
My wife, 66 years old, is facing mitral valve repair surgery. We are getting differing opinions on whether to have the minimally invasive or sternotomy. We are hearing the minimally invasive mitral valve repair has to be redone much more frequently than with the sternotomy. Does anyone have any long term experience with this.
Those who have posted that the waiting is the worst part are so true!
Thanks
Susan Lynn Jack - Minimally-invasive can mean different things when it comes to heart surgery. Full robotic is ... Read more
Susan Lynn Jack - Minimally-invasive can mean different things when it comes to heart surgery. Full robotic is a minimally invasive approach as is a mini-thoracotomy (side incision). I had a mini-thoracotomy mitral valve repair by a very experienced surgeon four years ago and so far, so good - no regurgitation.
The sternotomy is the quickest way to access the heart and usually has the shortest surgical time. The recovery is a little longer and the scarring and sternum healing are often less desirable for some patients.
It's a very individual choice. The most important part of OHS is an experienced surgeon and a good repair. Only the initial access is different, the procedure to repair the valve is the same. Best of luck with your research and decision. ❤
Deena Z Jack, I had a mitral valve repair through the sternum. If I had a choice to have the minimally invas ... Read more
Deena Z Jack, I had a mitral valve repair through the sternum. If I had a choice to have the minimally invasive with an OUSTANDING surgeon with outstanding outcome metrics, I would have. The recovery with the minimally invasive is much easier and faster, so much less blood is lost. In fact, the length of stay in the hospital is at least 40% less time (three days vs 5 or 6 days). As well, the surgeons are getting much better at the minimally invasive surgery. I had to go the sternum route because of my severe calcification, in others words, I had no choice.
That said, being a devil's advocate...: Some of the advantages of the sternum route is that the view of the valve is the best and (maybe) the ease to fix it is better, which is probably why you were told that the long term outcomes were better.-- When looking at the outcomes for "redone" surgeries, it is important to look at the most renowned surgeons and in the more recent years. Also, if there are any other valves that might need repair, then it can be done right then. My tricuspid valve was deemed ok on the TEE and ECHO, but when the surgeon looked at it when my chest was opened and tested it, it had enough regurg. that he put a ring on it. He wanted me to avoid having a possible second surgery in the future on the tricuspid valve, though who knows what the odds were for that. I don't think that minimally invasive is done on two valves in one surgery, but others can tell you if that is so.
Hope this info helps. Whichever choice you choose, look at the surgeon's outcome metrics. Go to someone renowned! Godspeed to you and most of all your wife.
Ginny Turner Hi Jack, a fellow Texan here from a little to the east of you in Crockett. I'm 72 and have severe mit ... Read more
Ginny Turner Hi Jack, a fellow Texan here from a little to the east of you in Crockett. I'm 72 and have severe mitral regurgitation, mild to moderate tricuspid regurgitation and a lot of PVCs. I consulted with a Texas surgeon who recommended a mini-thoracotomy surgery to repair or replace the two valves. Although I liked the idea of a smaller incision and shorter recovery time, what gave me concern was the surgeon's rate of repairs (70%) vs replacements (30%). He said he would not make that decision until he was in surgery. I wanted a very experienced surgeon who had higher rates of repairs - somewhere in the 90% range. I sought another opinion, and am now scheduled for a January, full sternotomy surgery with Dr. Marc Gillinov at the Cleveland Clinic. I would refer you to Dr. Gillinov's 2020 article: The 10 Commandments for Mitral Valve Repair (Google it) - lots of good information there. One of the 10 commandments is that the surgeon must choose the safest incision approach. In my case, because two valves are being repaired, plus a Maze procedure to address the PVCs, Dr. Gillinov said the full sternotomy is best. I agree with Susan's and Deena's comments above. There are a lot of factors that go into making that decision. But your best hope of a successful outcome is to choose a very experienced surgeon and team who have done thousands of the same surgery you will have. Welcome to the group and best wishes to you and your wife as you navigate the journey ahead!
I am from: Lorena, TX
The sternotomy is the quickest way to access the heart and usually has the shortest surgical time. The recovery is a little longer and the scarring and sternum healing are often less desirable for some patients.
It's a very individual choice. The most important part of OHS is an experienced surgeon and a good repair. Only the initial access is different, the procedure to repair the valve is the same. Best of luck with your research and decision. ❤
That said, being a devil's advocate...: Some of the advantages of the sternum route is that the view of the valve is the best and (maybe) the ease to fix it is better, which is probably why you were told that the long term outcomes were better.-- When looking at the outcomes for "redone" surgeries, it is important to look at the most renowned surgeons and in the more recent years. Also, if there are any other valves that might need repair, then it can be done right then. My tricuspid valve was deemed ok on the TEE and ECHO, but when the surgeon looked at it when my chest was opened and tested it, it had enough regurg. that he put a ring on it. He wanted me to avoid having a possible second surgery in the future on the tricuspid valve, though who knows what the odds were for that. I don't think that minimally invasive is done on two valves in one surgery, but others can tell you if that is so.
Hope this info helps. Whichever choice you choose, look at the surgeon's outcome metrics. Go to someone renowned! Godspeed to you and most of all your wife.