Non-Invasive Valve Replacement

[benny]

Hello everyone! It's good to be "back" again! Four years ago, I was here at this forum searching for answers for my then-upcoming Mitral Valve Surgery. I was able to get tremendous support from all the members here & had so much comfort knowing that when I went to the operating table, "everyone" here was with me. For that I thank you all from the bottom of my heart for being here. The people that run this forum is not only very informative & knowledgeable, but more importantly truly concerned for everyone undergoing the same experience.

At that time, my surgeon did not know whether he would repair the valve, or simply replace it. He mentioned that the only time he could make an informed decision was when he opened me up. Bless his heart he was able to repair it, albeit a time-consuming surgery.

Before the surgery, my wife & I asked him how long would the repair last. He looked us in both our eyes & answered matter-of-factly that he didn't know. 10 years hopefully, maybe 5, maybe less. Almost a month & half ago I started to feel very fatigued without doing anything strenuous, 2 trips to the ER, an echo that showed the valve was now leaking in 2 places, but no real damage to the heart. It turns out that this time, my surgeon said it was time for a mitral valve replacement. So we were able, at least, to get 4 years out of the repair. Although we wanted more mileage to it, unfortunately, that did not turn out to be the case.

Back to the same surgeon's office & we make an informed decision to do a mitral valve replacement this time with a mechanical one. I just can't see myself being opened up again for the third time. Now, here is where my question comes: My surgeon mentioned about a non-invasive procedure. He told me that he could do the replacement without having to open my sternum. Instead, he will go thru my left side &, I am assuming, break one of my ribs so that he can have access to the heart & then replace the mitral valve. Has anyone here at this forum experienced this kind of procedure? As far as I have learned through research on the internet, this procedure is being done only for repairs. But, of course, who am I to know? My surgeon told me that he is one of the pioneering doctors to do this procedure here in the West Coast. By the way, I implicitly trust my surgeon & I know of his reputation. His name is Dr. Hon Lee. But all I would like to know is if some of the members of this forum have undergone this same procedure & what are their experiences. I've heard that the recovery process is a whole lot faster than Open Heart Surgery. I am also hoping that this will now be the norm for all valve replacements.

Thanks so much for your time & I am glad to be back home.

Missed you all,

Benny

 

[Ross]

The heart port procedure. I honestly don't know if anyone here has had it, but it seems I do remember someone talking about it. Hang in there and let see.

 

[Nancy]

Joe's third heart surgery was the HeartPort method. It worked excellently for him. There was pain of course, but without the sternum pain. There are several small openings through which the instruments are inserted, and a cannula goes through the groin up to the heart like a cath.

I would say Joe's immediate recovery time was shortened by about a day and he was able to get around much sooner than with his prior sternum surgeries.

I think it was a very good option for him since his chest had been opened twice before.

It does go through the lung area. His ribs were spread, not broken.

I believe there are 4 or 5 people here who have had it done this way.

http://www.corvascmds.com/cardiac_surgery_heartport.htm

 

[hensylee]

we've had a couple where the surgeon went in via the side - maybe they will see this and drop in. One is a female but I can't recall who it is.

 

[geebee]

I am pretty sure Betty (bvdr) had the port. Perhaps you could PM her if she doesn't see this thread.
Best of luck to you on this surgery. It sounds like you have done all your homework.

 

[Karlynn]

I am pretty sure Betty (bvdr) had the port. Perhaps you could PM her if she doesn't see this thread.
Best of luck to you on this surgery. It sounds like you have done all your homework.

Yes, I believe she did. And Betty is a nurse, so she should be able to give you a pretty good analysis.

Best wishes and welcome back!

 

[Nancy]

Mamsram and DuchessBear also had it, I think. Also socworm who is labguides daughter

 

[baradonai]

Mitral valve installed through my side.

Mitral valve installed through my side.

I have about a 3.5 inch scar below my right chest area and a 3 inch scar on my left groin. What I was told was the valve went in on the right side and cameras and controls, etc. went in on the left. I do not believe any of my ribs were broken. I could be wrong.

Of course I was sore, (coughing was excruciating) but I was up and walking my daughter down the aisle in less than 4 weeks.

 

[tigerlily]

I have an aquaintance who had non-invasive surgery as you described for a mitral valve repair. I don't know if they could have done a replacement with the non-invasive or not. His surgery was at Duke University and was done by Dr. Glower. Perhaps you could get in touch with Dr. Glower to ask if this would be possible. here's a number for you. 1-919-681-5789. It's a place to start. He's an expert in mitral valve repair so if you can communicate with him, you should at least be able to see what's possible. Best of luck. I'm sorry you have to go through this again.

 

[bvdr]

Hi, I just noticed this thread. I had the heartport procedure for my mitral valve replacement. Dr. Glower was my surgeon and he is an expert at this procedure. My main incision was across the underside of my right breast and another incision right in line with it but closer to the midline but close enough they almost look like one continuous incision. As someone else mentioned, there was an incision in my right groin somewhat larger than that used for a heart cath and several other incisions of about an inch or so in length.

I think the procedure has some real positive aspects. That the sternum doesn't have to be split is a big advantage as well as being able to resume some activities such as driving much sooner. I'm not sure if it would be my choice again or not though. I remember severe muscle spasms in my right rib cage in the early post-op period. I also remember feeling weak as water and very short of breath the first few days. I do have a rib wired back into place and some lung scarring that the radiologist thinks is from the surgery itself. I never had a Chest CT before surgery so I don't know if that is really the case or not. I had radiation therapy as a teen-ager and I personally think that could also be the culprit. My cardiologist explained that in the surgery the right lung is deflated and moved out of the way to provide better access and that the lung sometimes takes a beating in the process. But I came through it and having a properly working mitral valve really made a difference in my life so I really have no right to complain.

The heartport is more technically difficult and the time on bypass is longer so that should be a consideration as well. I think Belgium is one of the countries where this approach has become the norm rather than the exception. I wouldn't call it non-invasive but rather less-invasive. Even cardiac caths are considered invasive procedures. I don't know if this helps but if you find you are a candidate for this then feel free to PM and I'll go into more detail if you like. Whatever way you choose I hope everything goes well for you and that it is your last heart surgery.

 

[labguides]

Our daughter had mini thorocotomy (cannot spell that word). The incision for mitral valve repair was under the right breast. There is no visble scar. Downside was that she was unable (afraid?) to use that arm. She had to have PT to regain the use of that arm. That seems like a minor downside for a young woman not having a visible scar. She was able to wear a strapless wedding gown at her wedding.

Surgeon -- Dr. Laks at UCLA.

 

[Andyrdj]

bvdr - Regarding your Belgium comment....

bvdr - Regarding your Belgium comment....

....about it becoming the normn over there? Sounds highly encouraging, makes me wonder whether to pay for a private trip there (I'm based in England).

I had already been considering Germany as an option, given that they seem to be quite forward looking I wonder if they might also have a decently high incidence of minimally invasive over sternotomies.

I think the incision across the breast area is called a "thoracotomy", and would appreciate more info from people who know more about them, and also the laparoscopy and robotic microsurgery methods.

 

[Andyrdj]

More news

More news

An interesting one by Edwards - I think a comparison of methods would be enlightening
http://www.freshnews.com/news/orange-county/article_28450.html

 

[joanne6]

Me too

Me too

There are several of us who has minimally invasive mitral valve surgery. I am sorry to hear your repair did not last longer. My surgeon is hoping for a longer period of time without any resurgeries.
As has been said the incision is under, or for men, across the lower part of the right breast, chest tube through right side under right arm, heart-lung bypass through right groin, one tiny incision at the midline area of the right breast. My recovery time was the same as sternotomy and the pain was just as bad but in a different location (locations). The big difference is the sternum was not cracked and wired together. I had no broken bones. Don't know about replacement being done this way but certainly ask the surgeon.

 

[charly]

I had hoped for this technique on my rereplacement

I had hoped for this technique on my rereplacement

Hey there,

My surgeon, Dr. Doug Murphy at St. Josephs in Atlanta, does this minimally invasive surgery. I was hoping that it would be an option for me back in 1997
when I needed a second aortic valve replacement, but I was advised that with scar tissue, it may not work, and that would require the surgeon to have to extend the surgery and open the chest.

At any rate, a 2nd surgery is "technically much more difficult," to quote my wonderful cardiologist, Dr. Claire Hochreiter in NYC, so we must choose the
2nd surgeon with great care.

Didn't know the lung had to be deflated with this technique.... that doesn't sound like much fun for recovery!!

best, Charly