"Mini" Surgery

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Pat J

Well-known member
Joined
Nov 19, 2012
Messages
45
Location
Valley Lee MD
I am going to have a "mini" as the nurse at Johns Hopkins described it, surgery to replace my aortic valve with a mechanical valve. In this surgery they only cut about half way down the sternum. Has anyone had this surgery and would you share yuor experience? Needless to say, I'm terrified as I have never had surgery before.
 
Hi Pat, my surgeon told me if all else was ok, they would do a mini surgery on me, however, when I woke up, it was the full "zipper". I too was very stressed out because either way, it is a major event! I had my aortic valve replaced but chose a tissue valve. If you are stressing too much about it, ask the surgeon or his staff to get a prescription to relieve the stress. I'm sure they would happily do it and it would probably make the days leading up to it easier. I will do that if I ever have to do it again.
As far as my scar goes, it is barely visible so I am ok with the way it turned out. My rationale was if the chest is opened completely, it allows the doctors the most access.
Either way, have faith the doctors have done it many times and for them, it has become almost routine! Best of luck! My surgery was Aug, 9, 2012 and it seems like a long time ago now!

Mike
 
Hi Pat,
Welcome to the forums! I hope reading here will help. When is your surgery?

Terminology is confusingly non-standard. My cardiologist called mine a 'boatneck' incision, but it sounds like yours. My scar starts about 5 inches below my collarbone, and descends about 5 inches. Even if it's a 'mini' to the nurse, it's still the full surgery--not at all the same as minimally invasive. I found this book very helpful (found it in the public library): Your Heart: An Owner's Guide by John A. Elefteriades. He explains that the sternum cut was chosen as the least painful route because the nerves from the spine don't extend that far around. Remember that you'll be unconscious during most of the scariest parts, and won't remember a lot because of medications.
I think there are Johns Hopkins 'graduates' here. You could post with that in the post title, or use the search function. You will certainly get the best care there. If you look in the POST-SURGERY forum, you'll find lots of experiences. Be sure to post with specific questions that arise, too.
 
My surgeon told me he would start with a mini (4 inch incision( but he might need more access. I ended up with a 6 inch scar, as he needed more access after he got started.
 
I had my aortic valve replaced with a porcine tissue valve about 3 months ago and my mini-sternotomy incision starts about 3 fingers down on the sternum and is just over 3 inches in length. Quite a few of the staff were surprised at how short it was and commented that it was the smallest incision they had seen. I was cleared (other than not doing stupid stuff) without weight restrictions by the surgeon 6 weeks after surgery.
 
I was also supposed to have a mini, but doctor said when they did the TEE just after they put me out, they found the heart was not only larger, but also deeper in the chest and he felt for safety, he would do the full cut. He told me there was no difference in rcoervery after the 3 month mark. I healed pretty well.
 
There probably is no difference in healing between a regular versus a smaller sternotomy. I had a small thoracotomy incision; it's between two ribs on the right side of my chest about 4 inches down from the collar bone. Though I have nothing to compare it to, I think my pain was far less than that of having any broken bone.

Not everyone qualifies for this approach, and not all surgeons do it, but it would seem to me it's at least worth asking about.
 
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