{"id":5535,"date":"2025-04-29T01:58:51","date_gmt":"2025-04-29T01:58:51","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=5535"},"modified":"2025-08-20T20:48:01","modified_gmt":"2025-08-20T20:48:01","slug":"scar-tissue","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/scar-tissue\/","title":{"rendered":"Surgeon Q&#038;A: Scar Tissue and Minimally Invasive Heart Valve Reoperations"},"content":{"rendered":"<p>With advances in heart valve surgery techniques and longer life expectancies, some patients with one open-heart procedure may require a second or even third reoperation. For example, children with congenital heart valve disease may need several surgeries into adulthood. Additionally, some adults with a tissue or mechanical valve replacement may require a re-replacement due to leaflet failure or infection. Regardless of the situation, the presence of scar tissue during a reoperation can make the procedure complicated.<\/p>\n<p>We received a great patient question about scar tissue and reoperations from Lynn, who asked, &#8220;If a person has had two open-heart surgeries to replace the aortic valve and has significant scar tissue, can they have a third, less invasive replacement surgery?\u201d<\/p>\n<p>To answer Lynn\u2019s question, we met with <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Patrick-McCarthy-Chicago-Illinois.php\">Dr. Patrick McCarthy<\/a>, the Executive Director of the Bluhm Cardiovascular Institute at Northwestern Medicine in Chicago. Having performed over 10,000 cardiac surgeries, Dr. McCarthy has extensive background with reoperative patients. He is also a celebrated surgeon among the HeartValveSurgery.com community, with over 200 patient recommendations.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/5j0DJ9gjV34?rel=0?si=JASDnxPDFz-RfA1U\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Facts About Scar Tissue and Minimally Invasive Heart Valve Reoperations<\/h2>\n<p>Here are the key insights shared by Dr. McCarthy:<\/p>\n<ul>\n<li>Scar tissue complicates reoperations. \u201cIt\u2019s a tricky problem when patients form scar tissue. It slows down the operation,\u201d said Dr. McCarthy. \u201cWe have to be really careful because we can\u2019t see exactly where the \u2018plane\u2019 is. We call it the difference between scar tissue and the aortic wall or parts of the heart. So, we have to slow down.\u201d<\/li>\n<li>Less invasive options may be possible for patients needing a reoperation. Dr. McCarthy said, \u201cYou can certainly do less invasive, as in transcatheter aortic valve replacement (TAVR). In many of those patients, the preferred option may be to avoid another open-heart operation. We can sometimes do the less invasive small incision with another open-heart operation. But again, it needs to be a very careful, controlled procedure. So, it can be done in some situations but isn\u2019t done all that often.\u201d<\/li>\n<\/ul>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5511 aligncenter\" style=\"max-width: 300px;\" src=\"https:\/\/www.heart-valve-surgery.com\/Images\/tavr-img-2.png\" alt=\"TAVR Valve\" width=\"300\" height=\"301\" \/>Transcatheter Aortic Valve Replacement (Medtronic)<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>How does the scar tissue slow down the surgery? \u201cThe scar tissue makes it difficult because it\u2019s like you put glue in there, and things get stuck together that aren\u2019t normally stuck together,\u201d explained Dr. McCarthy. \u201cAs you know, we need to have them separated as we\u2019re doing the surgery, and so we have to slow down and then we have to use an electrocautery or scissors to separate things and put them back to the way they\u2019re supposed to be. That adds time and can also add to the risks for bleeding. So, the second, third, fourth, fifth operations can be trickier, slower, and higher risk for bleeding.\u201d<\/li>\n<li>Patients should find a surgeon who specializes in reoperation techniques. \u201cThere are surgeons that do a lot of these types of operations,\u201d said Dr. McCarthy. \u201cThis is our routine at Northwestern and many of the big programs. But others may not see it all that often and many times will refer the patient out.\u201d<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>\u00a0Thanks Dr. McCarthy and the Northwestern Medicine!<\/h2>\n<p>On behalf of all the patients in our community, many thanks to <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Patrick-McCarthy-Chicago-Illinois.php\">Dr. Patrick McCarthy<\/a> for sharing his clinical experience and research with us. And, a special thanks to Northwestern Medicine for taking such great care of heart surgery patients.<\/p>\n<p>Related links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/dr-patrick-mccarthy.php\">Surgeon Spotlight: Dr. Patrick McCarthy<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2024\/05\/29\/dr-patrick-mccarthy-200-patient-reviews\/\">Dr. Patrick McCarthy Gets His 200th Patient Review at HeartValveSurgery.com<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/learning\/dr-mccarthy-mitral-annular-calcification\/\">Dr. McCarthy Q&amp;A: Why is Mitral Annular Calcification Difficult to Treat?<\/a><\/li>\n<\/ul>\n<p>Keep on tickin,<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard-of-hearing members of our patient community, we have provided a written transcript of our interview with Dr. McCarthy below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[8],"class_list":["post-5535","page","type-page","status-publish","hentry","category-before-surgery"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5535","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=5535"}],"version-history":[{"count":13,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5535\/revisions"}],"predecessor-version":[{"id":6160,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/5535\/revisions\/6160"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=5535"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=5535"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}