my experiences with minimally invasive vs. traditional approach Mitral Valve surgery

[offwego]

Wanted to post a few random thoughts on the differences between minimally invasive surgery and traditional sternectomy. There was and is such a warmer and fuzzier to be discussing such serious surgery as though it really is 'minimally invasive. WHo in their right mind would prefer the older more brutal style of sugary.

yet here I am 4 days after my second Mitral valve surgery and I am surprised the experience with the minimally invasive approach is less painful and it seems much easier to move around with out damaging the incision,

my memory of minimally invasive approach was a long sensitive and very sensitive reaction , The scare was nicer and neater and of course smaller. for a woman I could see this as much more into the aesthetic na43

 

[rubywhistle]

hi offwego so glad it has all worked out! Thanks for posting so quickly after the op

did u have the sternam route last time and through the ribs this time?

 

[offwego]

I just re read my post and I see it wasn't clear...Last time was minimally invasive through the ribs and this time was traditional...In my experience the minimally invasive surgery was much more painful...on a magnitude of 10x...no comparison...of course the scar was barely noticeable...My gut tells me that perhaps the reason I needed a reop was the difficulty of surgery via minimal approach method..Of course I can't really know and this is pure conjecture...But the difference in pain is so much different, of course again, I could be wrong as to the reasonings and everyone is different..I am very sensitive to pain...Each time I get out of bed I 'expect' it to be far more difficult...Sure it hurts and is sore but nothing major.

The worst of all was all the tubes and wires....torture...thank god they are out!

 

[rubywhistle]

Oh wow i thought it was the other way round well that what Drs say but i guess they dont feel it they just ask us to rate it out of ten!

so was first a repair and 2nd a replacement?

 

[Lynlw]

I just re read my post and I see it wasn't clear...Last time was minimally invasive through the ribs and this time was traditional...In my experience the minimally invasive surgery was much more painful...on a magnitude of 10x...no comparison...of course the scar was barely noticeable...My gut tells me that perhaps the reason I needed a reop was the difficulty of surgery via minimal approach method..Of course I can't really know and this is pure conjecture...But the difference in pain is so much different, of course again, I could be wrong as to the reasonings and everyone is different..I am very sensitive to pain...Each time I get out of bed I 'expect' it to be far more difficult...Sure it hurts and is sore but nothing major.

The worst of all was all the tubes and wires....torture...thank god they are out!

Ive heard a few people inluding surgeons, say in the begiining the min invasive (thru the ribs not smaller sternal incision) is MORE painful, mainly because they have to cut thru muscles which isn't an issue with sternal ones. Justin has had both, but he was a baby when he has his thoriacic incisions so i dont know if it was more or less painful for him. BUT he did have his sternum opened quite a few times in the passed few years and had below the sternum cut to have his pacermaker removes and also had muscles cut for his sternum infection, and he DID say the surgeries were he had his sternum cut and muscles, close together (days apart) and always says the sternum was never "painful" more uncomfortable , but the musles HURT.
of course it was all pretty controlled with good meds, but thats just his experience

 

[offwego]

Oh wow i thought it was the other way round well that what Drs say but i guess they dont feel it they just ask us to rate it out of ten!

so was first a repair and 2nd a replacement?

The first surgery was minimally invasive repair of the Mitral Valve...Leaks started a few years earlier and slowly but steadily worsened. Dr. Galloway (the original surgeons partner) said in this situation for various reasons he thought a traditional approach was better. He was not hopeful in a repair but he said of course he would repair it if he could...and from what he told mny sister it was a 'simple' job to repair it and it went (in his words) "perfectly".

I'm not saying there is no pain, of course there is, it's just not nearly as intense and as a result of less pain, I am finding recovery much less intense...last time I grimaced in pain with almost every movement...

I wonder how long it will take for the pain to go away and for the sterum to heal?

 

[Luana]

I just re read my post and I see it wasn't clear...Last time was minimally invasive through the ribs and this time was traditional...In my experience the minimally invasive surgery was much more painful...on a magnitude of 10x...no comparison...of course the scar was barely noticeable...My gut tells me that perhaps the reason I needed a reop was the difficulty of surgery via minimal approach method..Of course I can't really know and this is pure conjecture...But the difference in pain is so much different, of course again, I could be wrong as to the reasonings and everyone is different..I am very sensitive to pain...Each time I get out of bed I 'expect' it to be far more difficult...Sure it hurts and is sore but nothing major.

The worst of all was all the tubes and wires....torture...thank god they are out!

I had a minimally invasive AVR; I've never had a sternotomy, so can't compare, but my experience of pain was minimal; it would be hard for me to imagine it could be less. On a scale of 1-10, 10 being the worst, I'd say my pain was about a 3.

Seems I read so much about everyone feeling like they're been run over by a truck after traditional surgery, and back and neck pain lasting for months. I had none of that. I have been told years ago I have a pretty high tolerance for pain, but I think I'm kind of wussy.

Since muscle is cut going in between the ribs, it's logical it would be more painful. I found the pain to be minimal.

 

[Bina]

My surgeon told me that I would get the "full cut" since he needed a good look at my enlarged aorta,
and I had lots of calcification to remove.
The actual incision wasn't too bad, but my arm and ribs were very sore. And I did indeed feel like I had been
run over by a truck....

 

[offwego]

I don't know if I have a low or high pain tolerance....OHS is such a different kind of experience on so many levels...I really can't say with any degree of certainty which type of repair was harder to recover from because it's only a few days out...but just speaking of the pain of the incision area, it's much less this time around.

I am much better prepared for recovery this time. My expectations are lower and realistic...I assume to feel better than I have in a long time but that's clearly not a few day process...

After 4-5 days since surgery, I'm not going to go home, wake up, jump in the shower and go for a 3 mile walk...I know my body and I know I tend to overdo everything...maybe the trick this time around is to do less and trust I'll do what I have to do...also maybe much of the initial recovery is really through rest even more than exercise...I think the first surgery I was up and out and driving to the mall within 7 days and acting like nothing had happened..and I had a much harder time as I was in denial for a couple of months.

Now the game plan is that no matter if it's a 'good' day or 'bad' day,,it's one day closer to full recovery...the hardest part was getting this taken care of and I have to hold on tight to being grateful that it went so well, even though, yeah I feel like I got hit by a truck!

 

[Jkm7]

Actually, after both my OHS, I did go home and get in the shower from day one home. The first few times I made sure DH was around or someone else but I was able to shower and shampoo my hair just fine on my own each day. I started walking outside from day one but the first week or so, I was shocked at how weak I was and how short a distance I was able to walk. I carefully followed Mass General's walking schedule and by week two, I was walking just fine for considerable distances my second surgery. My first one took a bit longer for distance but I walked daily.

 

[offwego]

I remember just three weeks ago when I met with Dr. Galloway, I was so disappointed he would not do a minimally invasive approach...I had unreasonable and unrealistic views of what a traditional operation was like, at least from an incision standpoint.

I guess the best part of this thread is that we have great options...Hope to get checked out of here tomorrow...I am looking forward to getting home..and walking outside!