Minimally Invasive AVR??

[edjspi]

I posted this in reply to another post in a different forum, but I wanted to post it here to see if anyone has more info on this:

I am seeing that MITRAL valve replacements are now being done via minimally invasive techniques - AKA: no sternum cutting!

So I'm curious if anyone has or can point me to more information on minimally invasive techniqes for AVR?? I would love to know if they are doing it at ALL, and if not, where they are with testing it, etc.

thanks,
Eddie

 

[Ross]

As far as I know, it is not possible at this time, only Mitral.

 

[Nancy]

Eddie-

I know I have seen some about minimally invasive AVRs being done, but for the life of me I can't remember where. It's not common and there might only be a few places that do them at this time.

If I find a link, I'll post it.

 

[KathyH]

From what I've read what they consider minimal invasive for the aortic valve is just a small incision thru the sternum 3 inches. Don't ask me where I read that, but it was on line.
Kathy H

 

[Kevin M]

Kathy is right. Minimally invasive with respect to AVR is done with a smaller incision, but they still go through the sternum. My doctor's opinion is that it didn't make much difference with respect to recovery and that if they ran into any complication, it would hold them up with respect to getting in there. Of course, maybe my surgeon is just not a big fan of them. Others may have different opinions.

The procedure where they do not go through the sternum is usually done for repairs and less complicated procedures. They enter through a couple of ports they cut.

I wasn't aware that they could do a replacement through this method, but that's great if they can. It's that sternum that seems to cause the backaches, etc.

The 17 year old son of an associate of mine had a repair done in this manner. He was golfing in a matter of days. Mostly because he was able to recover quickly, but probably because 17 year olds are like rubber bands as far as bouncing back.
Kev

 

[spillo]

minimal avr

minimal avr

Hello,
For the record I am having an aortic valve replacement with a CE Perimount bovine pericardial tissue valve using a minimally invasive surgical platform on April 13th or so at the Cleveland Clinic.
The cut is from the top of the sternum to the 3rd rib down then perpendicular toward the side for 3 inches. Dr. Cosgrove helped develop it a few years back. He is doing my AVR surgery.
I was in an OR to see sternums being split. If they want need to, it dosen't take 10 seconds. The min. invasive cut however does speed recovery and lower infection rates, however small they are to begin with.
Spillo

 

[edjspi]

WOW spillo -

how did you get to see the OHS, and when was that? what was the actual cutting of the sternum and incision like?

does anyone know of a valve replacement surgery that can be viewed online? I used to have a link to one I think, but can't find it. I'm sure they have a taped surgery somewhere online??

I know you're thinking: "how strange - this guy who's about to have AVR wants to SEE one performed!" but there's gotta be someone else out there who's having or had AVR that would like to see it done. I was a bio/pre-med major... I'll blame it on that


-eddie

 

[RCB]

Watching OHS

Watching OHS

If you contact a teaching hosptal that does OHS, you may get permission to watch if they have a surgery theater. It would be extremely rare to be admitted in a regular operating room during surgery for a number of reasons- space, insurance, disease, pt's
rights, etc. I have seen it on pre-recorded videos many times.
If you have a satellite dish, U. of Washington has many lectures of different types of heart surgeries and heart grand rounds they
are very informative. Channel 9404 on Dish network system.
If you can't find it that way, most med. schools have a book store
where anyone can buy medical books and videos. They will be more then happy to sell it to you- you don't have to be a doctor or even
med. student to purchase things there. Be prepared for big $$$$.

 

[xtremlee]

I dont think I want to watch. I would throw up. My 14 year old watched it on the net last night and he about gaged.

 

[Rush20]

My surgery was a minimally invasive procedure to replace my bicuspid and leaking aortic valve (8/29/03). When my cardio told me I would need to have surgery, I almost fell out of my chair. It was a big relief that I was able to secure a surgeon that performed this surgery. It did help the healing process.

 

[spillo]

In the OR

In the OR

Hi Eddie,
- don't read this if you get faint easy -
I worked at the Cleveland Clinic for ten years in research in the dept. of artificial organs. We did artificial skin, blood, kidneys, spleen, heart, etc. You name it.
I have seen a ton of OH and other Surgeries on animals up to calf size but have only seen about a dozen or 15 or whatever OHS on people during those years. As long as didn't lean on anyone I could build up steps ( like aerobic step thingamabobs ) behind or across from a surgeon so you could get above them and watch it whenever the need to see a new something came up or if I just had some free time (never).
They just use blades, steel or electric at first and then an electric saw that looks like a drill with a broken circular saw blade on it, then a spreader which is like 2 opposing forks ( like salad pickups) with a gear to keep you open and thats it !
I used to stand and talk to the anethesiologist and perfusionist every day in the OR. Then the surgeon comes in.
The coolest thing is lowering the valve with what looks like a spider web of sutures.
I wished I had never seen it but I never saw them lose anyone either.
Take care, spillo

 

[ar bee]

videos and the like

videos and the like

i was curios as well, but after finding a link to an online (out of VR.com) I almost threw up, hence i cant remember the link - sorry :-((

well2u
ar bee

 

[xtremlee]

http://www.clevelandclinic.org/heartcenter/pub/guide/disease/valve/valvetreatment.htm#aorticmovie

here is the link