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Key Hole Surgery for Aortic Valve Replacement

A 38-year-old male, the Bus Conductor, who has diabetes, high BP, Hypothyroidism, has undergone back surgery in the past presented with breathing difficulty and was unable to walk for long-distance. He was diagnosed to have a leaking aortic valve. He underwent key hole surgery for aortic valve replacement. In normal surgery, the whole chest bone is cut, but in this surgery, only one-third part of the bone is cut. He was discharged on 4th day and has resumed his normal duties.

Advantage of this surgery are less pain,early recovery and ability to resume normal duties in a week.

In the standard procedure, full sternum (breast bone) is fully divided to access the heart (called a sternotomy). In the minimally invasive approach (referred to as mini-AVR) a smaller incision is used, only the top third of the sternum is divided. This is usually a 2 – 3-inch vertical incision.

The Benefits of Mini-AVR include:

keyhole surgery heart valve repair

Minimally invasive surgery confers many advantages over standard approaches derived largely from the reduced trauma to the chest wall tissues. The benefits of minimally invasive cardiac surgery include:

  • Smaller incisions
  • Smaller scars
  • Reduced infection risk
  • Less blood loss
  • Less pain
  • Shorter hospital stays. Stays after minimally invasive operations are from 3 to 5 days compared to 5 to 7 days for traditional sternotomy-based cardiac operations.
  • Fewer physical restrictions. Patients undergoing standard incision cardiac operations are restricted from driving an automobile or lifting objects weighing more than 1 kg while patients undergoing minimally invasive cardiac surgery are not subject to these restrictions
  • Shorter recovery time. Recovery times after minimally invasive operations are from 2 to 4 weeks compared to 6 to 8 weeks for standard sternotomy-based cardiac operations
keyhole surgery heart valve repair

Over the past decade, minimally invasive cardiothoracic surgery (MICS) has grown in popularity. This growth has been driven, in part, by a desire to translate many of the observed benefits of minimal access surgery, such as decreased pain and reduced surgical trauma, to the cardiac surgical arena.

Initial enthusiasm for MICS was tempered by concerns over reduced surgical exposure in highly complex operations and the potential for prolonged operative times and patient safety. With innovations in perfusion techniques, refinement of transthoracic echocardiography and the development of specialized surgical instruments, cardiac surgery was provided with the necessary tools to progress to less invasive approaches.

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