Anyone had the surgery where they dont go through the breast?

[oopsyadaisy]

I have heard of the surgery where you do not have to go through the breastbone. It is around the armpit area. I do not know if this surgery is only for a repair but the surgery healing time is way better and infection is minimal. Has anyone here heard of it or got it done?

 

[Harpoon]

Yup, I believe it's for working on the mitral valve too, ie. MVP...


The surgeon will decide what the best approach is of course giving your concerns a lot of consideration. The incision is a few inches (a few more centimetres) below the armpit I believe on the right side and they work between the ribs. They may actually take one out for space then put it back when their done, but I'm not sure.

Some valve surgery is also being done laproscopically in a few places, but that's still a real big specialty and not every heart center that treats valve issues will have that capability in their arsenal.


The recovery time for going through the sternum (breastbone) isn't exactly short, it can take upwards of a year for the sternum to completely heal, but it's not terrible either and they'll give you whatever you need for pain management because the less comfortable you are, the longer your recovery time will be.

Generally most folks spend a few days in the hospital before coming home from surgery (I was quoted at 7 to 10 days when I had my tricuspid valve replaced) and another two months roughly before they could resume lifting heavy stuff or be as active as they might have been before getting sick.

Cardiac rehab also helps a lot in your recovery and is really worth pushing for.


In addition to all of this, healing and recovery times vary for everyone. Some people are out and walking a mile or more only a few days or so after getting home from the hospital. Some may take a few months before they're "back to normal" though that's fairly rare these days and usually involves having other, "complicating" factors in their condition.


Going through the side to repair/replace a valve IS done, but I'm not sure it would be available everywhere and it really depends on your specific condition and circumstances.

 

[Nancy]

My husband has had both the sternum approach and the HeartPort approach, for a Mitral repair.

For the HeartPort approach, through the side/rib area, the ribs are pulled apart some to gain access (not, hopefully, broken). You will have a surgical site there, and several other smaller incisions for instruments, etc. Then there is a larger incision under the breast in that area, and a larger one in the groin area.

For my husband, the recovery was easier by a couple of days early on. The long term healing is about the same as for the sternum approach, because the heart has been operated on internally.

The surgical time was perhaps the same or a little longer because there is a lot of delicate setting up done, getting cannulas from the groin to the heart and setting up the instruments, etc. getting back out again takes time too.

The surgeon has to be highly skilled and not every surgeon can do this, also not every hospital has the equipment. And the patient has to have good blood vessels. I don't believe every surgery could be done this way. You'll have to do some interviewing and lots of research.

Joe was very pleased with the results, as was a friend of the family who was operated on using the same method, by the same surgeon for a heart tumor.

 

[oopsyadaisy]

I want this done

I want this done

Here is some more info. There is only positive and people need to be informed that they have a choice.
http://www.hsforum.com/forum/thread?table=Mitral+valve+surgery+from+the+right+side

 

[Nancy]

We have several members who have had this type of procedure.

Mamsram
Nancy (husband Joe, patient)
bvdr
DuchessBear
Helene Smith

I am sure there others. This has been discussed many times. You can do a search here on "minimally invasive" and come up with many posts, also try Heartport and also "port access". You can also look at the members list and look at the above names and find the posts that apply.

Some of the above members haven't posted in a while, but the information is still there in the archives and will appear in a search.

Hearing what surgeons have to say is interesting, but even more interesting from the patient point of view is how THEY felt about the surgery.

 

[labguides]

Our daughter had a right mini thorocotomy for mitral valve repair Jan 2004. Problem -- moving her right arm. She had to have some physical therapy to speed recovering the use of her right arm. Also right lung did not want to re-inflate completely which led to pleural effusion. She is delighted to have had this type of incision.

 

[bvdr]

I had the Heartport procedure for mitral valve replacement last August. In my case, a rib was removed and wired back into place afterwards. I did have some pleural effusion (which is common regardless of the surgical approach) and have scarring in my right lung. It was a long surgery and I still feel some "pump headedness". I also had some CHF and problems with atrial-fib...but I had had both of those pre-op as well. Of course I had no problems with my sternum other than a little soreness. Most of my pain was from muscle spasms in my ribcage. I had the usual pacer-wires, chest tubes, and drains as the more traditional approach. My surgeon was a specialist in this technique and I felt I had excellent medical care.

I'm not sure I would do it again with the Heartport approach. I'm not comfortable about the lung damage. The right lung is deflated for the surgery and is pushed out of the way. Sometimes it doesn't take too kindly to this unexpected treatment .

Regardless, everyone has to make thier own choice. Best of luck with your research and in finding what is right for you.

Remember, the surgery is the same once they get inside. If you have "beating-heart" surgery then you are speaking of something different than what some of us have had.