mitral repair/minimally invasive

[NancyMVP]

A lady I know had mitral valve repair several weeks ago. I saw her this morning. She knows I have mitral regurgitation we talked about how we had the same condtion.
I just recently found out that my regurgitation went from moderate to severe to severe. Although my left atrium is still ok. It is slightly dialatd. I see my cardio in January of 2004.

She told me it was much more painful than she anticipated. She said put if off as long as you can.

She had it down by Stephen B. Colvin, M.D at NYU Medical Center here in NY. I asked her about the incision and she showed it to me this morning. I was so surprised to see it was on the right side. Under the breast. Also a couple of small marks on the right side as well. She had the minimally invasive procedure.

 

[HFK]

NANCY,
I TOO NEED MITRAL VAVLE SURGERY IN 6 TO 24 MNTHS. IT CANT BE REPAIRED SO IT MUST BE REPLACED MY RANGE ON ECHO IS MOD TO SEVERE. I HAD REPLACEMENT ON MY AORTIC VALVE 3 YRS AGO AND THEY SCREWED UP MY MITRAL VALVE AND I ENDED UP WITH A PACEMAKER . I AM NOW 45 . DO YOU HAVE SYMPTOMS?

 

[Nancy]

Hi Nancy-

My husband had his mitral valve repaired the same way, It's called the Heart Port procedure. bvdr (Betty) just had her surgery this way.

They do not go through the sternum, they go through the side in between one of the ribs.

The surgeon uses a cannula from the groin area to reach the heart. There is an incision under the breast area and there are several other small incisions in the side and chest area for instruments. So there's a larger incision in the groin and under the breast and a couple of smaller ones in the chest and side area. Even though it's still major surgery with all the attending temporary pain, there is not the sternum pain because the sternum isn't split.

My husband has had two heart valve surgeries through the sternum and then had his mitral repaired this way. His in-hospital recovery from the Heart Port procedure was at least a day ahead of what it would have been with the sternum, and his overall recovery was much easier than it was with either of his traditional methods.

We also have at least two other members who have had their surgeries this way, Duchess Bear and Helene Smith. Helene Smith and my husband had theirs done by the same surgeon, Dr. Harry DePan.

Not every patient is a candidate for this procedure and not every surgeon does it, but if it can be done, it offers many advantages. I think Joe is unique in that he has had it done both ways and found this to be superior, pain-wise and recovery-wise.

Here is a link to Mt. Sinai which describes the procedure. Dr. Colvin there does it also.

http://www.med.nyu.edu/hcsolutions/minim/minim.html

Hi HFK-

Welcome to the site. You'll find wonderful people here and we all understand about this surgery. So we'll help you get through this surgery.

My husband has had 3 valve surgeries and also has a pacemaker.

Sorry you both will be facing surgery, but you've found the most supportive place to be.

Take care,

 

[Georgia]

Hi, Nancy and HFK

Hi, Nancy and HFK

hfk - glad you made it to our site.

I had a mitral valve replacement in Feb. 03. It was supposed to be a repair, which didn't work. At 7 months out, I can't tell you how much better I feel than I have for a couple of years. I just didn't know how deconditioned I'd become. The mitral valve thing is very sneaky.

That being said, I think you'd be ill-advised to try to put off surgery. I am a wimp (it should be tatooed across my forehead); but the pain from this surgery was WAY less than I had for a rather botched wisdom tooth extraction. Lasted longer, is more stressful, requires more patience, yes; but the people involved in the surgery and recuperation are dedicated to elimination of pain. Their goal is to get you up and breathing well; you can't do that if you hurt very much at all. Therefore, I think they control post surgical pain better for this than they do for other, less critical surgeries.

We've all been where you are; it's terribly frightening. But the better physical shape you're in going into surgery, the better you'll do in recuperation.

 

[MelissaM]

The first thing the docs at CCF said to me was "minimally inasive surgery is a complete marketing scam - there is nothing 'minimally invasive' about having your heart worked on." Having said that, I had a mini-sternotomy, which resulted in a 4-inch scar. The closure was done with subcutaneous stitches, and the scar will be "minimally noticable" in about six months. This is great!! I also feel having the mini-version got me up and about more quickly than a full steronotmy because there was all kinds of sternal material still supporting the ribcage.

The downside (just recently discovered!) is that because everything is done laproscopically, complications can develop. For me, it has led to pericardial effusion - fluid around the heart - possibly from a teeny-tiny vessel not be sutured. I think this type of complication can occur regardless of whether or not you go minimally invasive, but it is my impression certain complications/risks can increase with this method.

Good luck with your surgery and keep us posted!

Melissa

 

[NancyMVP]

Hi Everyone,

HFk - I'll be 44 this October and I've been getting regular checks since October of 2000. I seemed to be having some symptoms then. I'm taking medications atenonol and accupril. I'm feeling ok. I don't have the energy I had 10 years ago. I can't say I'm having symptoms such as shortness of breath. I do have general fatigue. I'm a pretty active person. My cardio said my echo showed no real change. He left out that it went from moderate to severe to just severe this past echo. I requested a copy of the report. He doesn't seem to be an alarmist. My ejection fraction is 65%.


Hi Georgia,
Yes sometimes they can't really tell if the valve is repairable.
I'd hate to have the repair and then have to go back in for the replacement. I've heard of people in the group that its happened too. Hope your doing well. Looks like you have your hands full.
My children are 20, 17 and 13. I don't plan on anymore.


Hi Melissa,

Yes its still a major big deal. Yes I think you have a point about one type might have different risks than the other etc.
I'm still in the waiting stage of this whole thing. I'm not scheduled for surgery at this time.

Hi Caitlin,

I guess fear will kick in for me when they tell me I need the surgery and to see a surgeon. For now I try not to think about that. Just to continue taking my meds and seeing my doctor.
I be afraid to wait to long and have to get the replacement if I could have had the repair if possible. I'm keeping my weight down. I think that helps how I feel.

What is CABG?
So I guess you may need your surgery soon. Let us know how your appointment goes.

Hi Nancy,

So you saying that Joe found the minimally invasive to be less painful and a faster recovery as compared to the traditional sterum incision.

Yes I believe my friend went out of network to have her surgery done by Dr. Colvin.

I've looked at many sites that tell about the minimally invasvive procedure. I will check that one out for also.

It was interesting to actually see someone and to ask her myself her experience. In person etc. She's a bit older than I am. But shes doing ok.

Joe must be so happy to have you. Your such a supportive loving wife. Does he like to read the posts?

Take care Thanks for all your input. Its good to know others expericences.

 

[LUVMyBirman]

Hi Nancy,

Great to see you You have been so very fortunate thus far....holding off surgery.

Myself, I had full chest and beleive it or not, don't recall that much pain. Though, as Melissa pointed out...my mobility did not return as quickly as hers did.

I did however have a 'cardiac tamponade' 3 weeks post op. Darn painful, similar to an effusion. But lets times that by 10.
Another 10 days in the hospital and a second surgery to drain 2 liters of fluid from around my heart. My surgeon informed that some individuals are just prone to it. They also stated it could happen again with another surgery. I did hear that the "less invasive" proceedure where they go in between the ribs is much more painful. If I had to do it all over again....I would go full chest. Always that chance they will have to make another incision if they can't get a full picture.

Nancy, wishing you all the best. My case was one of the extreme examples. I am sure you will not fall into that catagory. You are taking the proper steps and doing your homework. Please keep us posted.

 

[Nancy]

I'm not so sure that the Heart Port or port access surgery is more painful than full sternum. Joe didn't feel it was and he's had two sternum surgeries prior. He did have it for a repair and not a full valve replacement. However, for him, the "gold standard" of surgical pain is lung surgery. He thought that the pain from lung surgery (he's had 2 of them) was much, much worse than any heart surgery he's ever had. Plus he's got a high threshold for pain. He really does ingnore a lot of it and rarely complains.

He found the port access to be a much easier surgery all the way around.

Not everyone can have this procedure, not every problem can be addressed this way and the surgeons who do not do it, do not speak well of it, simply because they don't do it.

 

[bvdr]

I guess the best approach is whatever they need to do to do the job properly. Some of it is just perception. An old friend called me yesterday and said how pleased she was that I didn't need open-heart after all.

 

[HFK]

hi,everyone i am new to the site and the computer still trying to figure out how it all works. its so nice to have a sight where everyone has a common denominator and knows what this type of surgery is all ABOUT. hfk