Why not choose minimally invasive surgery?

[TempleR]

I've known for many years that my aortic valve is biscupid and that one day I would need a valve replacement. I am 49 and my cardiologist says that the time has come. Thank you everyone for your posts to this site. It has been very helpful and educational.

I have a couple of questions that I havent seen addressed. First, has the Ross procedure fallen out of favor as my cardiologist suggests? Second, is there any good reason why I wouldn't choose minimally invasive surgery instead of traditional surgery which has a muchlonger recuperation time?

Thanks again everyone. This site is a wonderful community service.

Ronny Temple

 

[ALCapshaw2]

Some surgeons have had disappointing results with the Ross Procedure (including those at the Cleveland Clinic).

OTOH, there are a few Top Gun Ross Procedure Surgeons (Dr. Paul Stelzer in NY and I think Dr. William Ryan in DFW, TX) who seem to have a good track record.

I would think that minimally invasive surgery is not recommended for BAV patients, especially if the Surgeon wants to inspect the Aorta for signs of Connective Tissue Disease and particularly if you have an aneurism that need to be removed and replaced.

'AL Capshaw'

 

[john79t]

Yep I ask my sergeon about MI but my aorta needs some attention also. He said open chest would be much better. He has done hundreds with great results I trust his judgement.

 

[pamela]

When the incision for minimally invasive surgery is made, they make a lateral cut across the grain of your chest muscle fibres rather than longitudinally with the grain. This can make healing difficult for some. The rib spreading can create fractures as well.

My surgeon explained that The Ross Procedure was, in effect, replacing two valves when only one needs work, creating risk that both aortic and pulmonary tricuspid valves would require replacement annnnnd increasing the time on bypass pump needlessly. He convinced me, even though I had entered the surgical venue fully intending to research and have The Ross performed as my valve replacement.

Of course, since I was bicuspid, my doctor wanted to be certain he had full access to my heart from all angles. He wasn't certain, either time he was in my chest, that my mitral valve was going to stay native or if he'd need to replace it as well.

Research everything, write everything down that concerns or confuses you, ask your doctor and surgeons everything until it all is satisfactory IN YOUR MIND and YOU understand. That is what is important. Understand what they're talking about. They will translate to plain speaking if you're persistant and confident.

Take Heart and good luck with all of your decisions.
Pamela.

 

[Lisa in Katy]

Can't really respond to your questions as I had mitral valve replacement via the old fashioned surgery, but wanted to welcome you to the site and wish you good luck in your research and health.

 

[Eva]

Ronny,

Just to welcome you aboard and wish you good luck.

 

[MissMelis]

Hi,

I had the Ross procedure myself. At the time I chose it over a "simple" AVR because while it can make a one-valve problem into a two-valve problem, my surgeon explained that if I did need another valve replacement in the future, it would like be a pulmonary valve replacement which is easier to do than aortic valve replacement.

That being said, I am almost 4 years post-op and have developed an aortic aneurysm that is a direct result of the Ross procedure. I am told that up at the University of Alberta, where I had my surgery, they are looking at altering this procedure after similar situations with other patients. They would "sheath" the aorta from the get-go, from what I gathered.

You must do what is best for you - gather opinions from your cardiologist and surgeon(s), and that will help you decide.

Good luck and take care!
Melissa

 

[EVELYN]

Hi Ronny

My husband had AVR almost 7 years ago. When we inquired about the minimally invasive procedure, our surgeon told us straight up....."If something goes wrong and I need to get in there, I want all the room I need." That was why he didn't do the minimally invasive procedure. Luckily, all went well and he didn't need it, but I certainly was understanding of his answer and appreciated his honesty.

Evelyn

 

[halleyg]

Hi Ronny,
My first surgery was minimally invasive and I had a much more difficult time than I did with the second one, in which I had the traditional sternum incision.. my experience with min. inv. was very painful, I was actually in the hospital a full week. BUT, I hear all the time of people having minimally invasive heart surgeries and having shorter recovery and less pain.. it just didn't work out well for me. I would never suggest not to do it or look into it, just make sure the dr. has a good track record of success. I didn't know the right questions to ask at the time, so that i something I've since learned. Lots and lots of questions! Good luck.

 

[gustaf]

I have had both. The OHS was clearly a much larger procedure and took time in recovery, but in my case there were no options.

I did however experience issues with my minimal-invasive procedure, and it did show some its risk and limitations. I lost a lot of blood and had my femoral artery trashed (bleeding and thrombosis). I ended up with a long vascular surgery, continued internal bleeding and muscle damages in my leg which will take a long time to heal. If something would have gone wrong with the heart part of the surgery (aorta dilation with a stent) there would have been very little time and option to improvise.

::g