Heart valve repair or replacement (minimally invasive)

Heart valve repair or replacement (minimally invasive)

Overview

Cardiovascular and Thoracic Services offers a variety of minimally invasive surgical procedures. Our Cardiac Surgery Services performs some of the most progressive and effective types of treatments on congenital heart disease, mitral valve prolapse, arterial blockage and other heart diseases. The procedures are performed in a hybrid operating room / catheterization lab where combined angiographic, interventional and complete open-heart surgical procedures can be performed in a single space.

Where appropriate, they offer an alternative to some of the more traditional open surgical approaches. These advanced procedures are performed through small incisions between the ribs, using specialized instruments. The breast bone does not need to be cut through and the chest opened (sternotomy), as is done in open-heart surgery. Additional benefits include:

  • A decreased risk of infection
  • An earlier return to normal activities
  • Faster recovery
  • Minimal scarring

Types

Several methods of surgery are available:

  • Minimally invasive mitral valve repair – Our Center offers patients with mitral valve prolapse the possibility of a less invasive operation. The operation is performed through a three-inch incision between the ribs on the right side of the chest. Valve repair or replacement surgery is used to repair the flaps (“leaflets”) of the valve if they do not open up wide enough to allow sufficient blood flow through the valve into the artery. If the leaflets do not close tightly, blood can leak back into the heart’s chambers.

     

  • Transcatheter aortic valve replacement surgery (TAVR) – When the heart’s aortic valve becomes narrower than normal and impedes the flow of blood, the condition is known as aortic valve stenosis, [link to condition page] or aortic stenosis, and can cause life-threatening impairment of heart function. In cases of severe aortic stenosis the valve must be replaced, which has traditionally required open-chest surgery. Unfortunately, this surgery is often considered too risky for many patients, especially older ones.

    TAVR is a minimally invasive treatment alternative to traditional open-chest surgery. This breakthrough procedure, performed through an incision between the ribs to avoid splitting the breastbone, provides a potential lifeline for the highest-risk patients with severe aortic valve stenosis and can result in both longer life and better quality of life. For patients who require aortic valve replacements and are considered good candidates, minimally invasive techniques include partial sternotomy.

    During the transcatheter aortic valve replacement procedure, the cardiac surgeon inserts a replacement aortic valve in the area of the patient's own aortic valve, through a small puncture in the femoral artery of the leg or through a small incision in the side of the chest.
     

  • Robotic heart surgery – The Minimally Invasive and Robotic Heart Valve Surgery Center is the first center on Long Island to use the Da Vinci® surgical robot. This system includes small instruments which are inserted between the patient’s ribs without splitting any bones. The miniature instruments are guided by and replicate the surgeon’s hand motion through information from a console in the operating room. A monitor enables the surgeon to see the instruments and adjust movements accordingly. This technology has enabled some cardiac procedures to be performed less invasively without sternotomy.

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