Minimally invasive mitral valve repair

Overview

Minimally invasive mitral valve repair is a surgical procedure to correct issues with mitral valve. The mitral valve maintains the proper direction of blood flow between the left ventricle, the lower left heart chamber, and the left atrium, the upper left heart chamber. If a patient’s mitral valve is not functioning properly, they may require mitral valve repair.

The procedure will be performed using one or more tiny chest incisions, the surgeon will introduce tiny surgical instruments and cameras while performing minimally invasive mitral valve surgery with the use of surgical robot. Compared to traditional open-heart surgery, which requires a lengthy incision along the front of the chest, this method is less invasive.

Types

The surgeon uses a number of methods when performing minimally invasive mitral valve repair. An annuloplasty is one technique for addressing leaking in the mitral valve. A metal ring or mesh is positioned strategically around the valve.

The surgeon may also:

• Enhance the secure connection of the valve flaps.
• Repair a hole in your heart valve.
• Eliminate surplus tissue obstructing the proper closure of valve flaps.
• Unbind valve flaps that have become fused together.

Reasons for undergoing the procedure

A mitral valve repair may be necessary for the patient if they have:

• Mitral valve regurgitation: Blood can leak backward through the mitral valve because the flaps don’t close completely between heartbeats.
• Mitral valve stenosis: The mitral valve flaps harden and may even fuse together. As a result, the mitral valve narrows and blood flow is reduced.

Minimally invasive mitral valve surgery may be appropriate for patients with mitral valve regurgitation or stenosis. Their eligibility as a candidate is based upon different factors such as:

• Condition of the heart.
• If further operations are required for the patient at the time of mitral valve surgery.
• Certain individuals may not be suitable candidates for surgery, including those who smoke or have a body mass index (BMI) higher than thirty.
• If a patient has severe aortic valve disease or coronary artery disease, they might not be a good candidate for surgery.

Risk

Risks associated with minimally invasive mitral valve surgery include:

• Bleeding
• Blood clots.
• Infection.
• Arrhythmias or irregular heart rhythms.
• Stroke.

Before the procedure

The patient is given instructions by the surgeon on how to be ready for a minimally invasive mitral valve surgery. To assess blood flow through their heart and have a closer look at their heart valves, patients may undergo procedures like echocardiograms.

The patient could also require a CT (CAT) scan and a cardiac catheterization to check the arteries in their heart.

During the procedure

The cardiac surgeon does a minimally invasive mitral valve repair by:

• On one side, surgeon make an incision between 4 and 6 centimeters along the ribs.
• Passes an instrument through the incisions to observe the mitral valve, called an endoscope, which has a camera on the end.
• Uses tiny surgical instruments to repair the mitral valve.
• Uses stitches to close the wounds.

The average time for minimally invasive mitral valve repair is two to four hours.

After the procedure

After undergoing mitral valve repair surgery, patients typically spend one to two days in the intensive care unit (ICU). To prevent the accumulation of fluid around the heart, temporary chest drainage tubes may be inserted.

Following their initial ICU stay, patients are transitioned to a different room for further recovery. Usually, within a day or two after surgery, the medical team assists the patient in standing and taking short walks. To remove the fluid in the lungs, the healthcare providers may recommend breathing exercises to improve lung function.

After this initial recovery phase, patients can expect to remain in the hospital for an additional up to five days before being discharged to continue their recuperation at home.

Outcome

Mitral valve issues can be successfully treated with minimally invasive operations, which also have the following advantages:

• Faster recovery time
• Less pain
• Reduce the usage of painkiller or opiods
• Lower risk of infection
• Lower blood loss.
• Reduced scarring.
• Shorter hospital stays.

After surgery, the patient could experience prolonged periods of fatigue. During this follow-up meeting, the surgeon provides them with guidelines regarding when they can resume employment and other activities. Over several weeks, the patient must refrain from doing any strenuous lifting.

A cardiac rehabilitation program may also be recommended by the healthcare provider for the patient to successfully complete. These programs assist them in safely increasing their levels of activity. They might also assist patients in forming better routines, such eating a balanced diet and getting frequent exercise.

If a patient experiences any of the following symptoms after undergoing mitral valve surgery, it is crucial for them to seek immediate medical attention:

• Pus or drainage near the site of the incision.
• Excessive redness or swelling in the area surrounding the incision.
• Fever.
• Heart palpitations
• Unusual foot or leg swelling or fluid retention (edema).
• A weekly weight increase of more than three pounds.