Heart Valve Replacement: Minimally Invasive Methods

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Heart surgeons can also use less invasive methods for heart surgery. In conventional open-heart surgery, the surgeon makes a long incision [about 12 in. (30.5 cm)] from the top of the rib cage to just above the navel and then spreads the ribs to expose the heart. This type of incision is called a sternotomy.

In minimally invasive heart surgery, the surgeon makes an incision in the chest that is less than one-third of the size of the incision used for conventional heart surgery [less than 4 in. (10.2 cm)]. The aortic valve is located near the front of the chest. So surgeons have discovered that aortic valve replacement can be performed successfully through this smaller opening.

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Surgeons may perform this minimally invasive surgery in different ways. These variations include different ways to:

Bypass the heart with a heart-lung machine.
Protect the heart during surgery.
Make the incision in the chest to access the heart.

Despite these variations, in all other ways the technique for replacing the aortic valve is the same in minimally invasive surgery as in conventional valve surgery.

What is the bypass method?

Another variation in technique that you may notice after surgery is the method that your surgeon uses to access one of the arteries and one of the veins to bypass the heart with a heart-lung machine. In many cases the surgeon will attach the heart-lung machine to a vein and artery in the chest. But in some minimally invasive surgery procedures, surgeons have experimented with different heart bypass methods. One method involves accessing the femoral artery, which is in the groin area at the top of the thigh. If your surgeon uses this method, you may experience some tenderness or soreness in the area where the tube was placed in your artery. But it appears that most surgeons still perform heart bypass through arteries and veins in the chest.

What are the potential benefits of minimally invasive valve replacement surgery?

Less invasive surgery can have benefits over conventional valve replacement surgery. These benefits include:

Less blood loss during surgery.
Reduced need for blood transfusions.
Reduced chance of irregular heartbeat during surgery.
Possibility of removing the breathing tube sooner after surgery.
Less pain during recovery from surgery.
Shorter hospital stay.
A smaller scar.
Lower risk of infection.
Easier treatment in cases of infection.
Quicker recovery and return to previous level of activity.
Lower overall risk of complications, including death.

What are the controversies over these benefits?

Researchers are still studying the results of minimally invasive surgery to figure out whether all these benefits can be attributed to this technique. Some studies have found that people who had minimally invasive surgery enjoyed many of these benefits. Other studies have found that there has not been a significant difference between minimally invasive surgery and conventional valve replacement surgery, at least in some areas of potential benefit.

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WebMD Medical Reference from Healthwise

Last Updated: November 04, 2009

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.