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Heart surgery with a sternotomy vs. minimally invasive cardiac surgery

Is it better to repair a mitral valve with minimally invasive cardiac surgery instead of open-heart surgery? Is it common for a surgeon to have to switch from an open-heart procedure to a closed-heart procedure once the surgery has started?


Both minimally invasive cardiac surgery and classic sternotomy surgery, which includes opening the chest bone, are safe and effective techniques to replace a damaged mitral valve. The minimally invasive method takes less time to recuperate from and has a lower risk of consequences. Patients are rigorously examined before to surgery to ensure they are suitable candidates for the minimally invasive method, therefore it is uncommon for surgery to be changed while it is being performed.

The mitral valve is located on the left side of the heart, which collects oxygen-rich blood from the lungs and pumps it throughout the body. The mitral valve, which is located between the upper left chamber (left atrium) and the lower left chamber (left ventricle), has flaps that open and close once per heartbeat to allow blood to travel through it.

For a variety of causes, the mitral valve may need to be repaired. A disorder known as myxomatous degenerative mitral valve disease is one of the most common. The valve flaps grow floppy, and the strings that support the flaps become extended and may eventually break in persons who have this illness. When this happens, the valve becomes unable to seal properly, allowing blood to flow backward into the left atrium and into the lungs.

A damaged mitral valve can often be repaired, and rather of a sternotomy incision, it’s common to execute mitral valve surgery utilizing a minimally invasive method. Both procedures are classified as open-heart surgery and necessitate the use of a heart-lung machine.

The surgeon makes multiple small incisions between the ribs to obtain access to the heart during minimally invasive cardiac surgery. Surgical equipment and a small, high-resolution camera are then put through the perforations. The surgical instruments are attached to robotic arms that the surgeon controls via a computer.

The surgeon can make incredibly accurate motions with the surgical instruments since they are so small and the surgeon can view their movement in great detail on a computer monitor. In comparison to a sternotomy, this permits the surgeon to complete the procedure with less manipulation and stress to the heart and chest wall.

Sternotomy usually necessitates a six-day stay in the hospital and a six-to-eight-week recuperation period. The hospital stay for the minimally invasive operation is normally three to four days, and full recovery takes three to four weeks. Complications, such as infection and excessive blood loss, are less likely, and patients have less pain after minimally invasive cardiac surgery. During a mitral valve surgery, a surgeon rarely switches from a minimally invasive method to a sternotomy. However, in the event of an emergency, the operating crew is prepared to do so.

Patients are thoroughly screened to determine that the minimally invasive method is the best option, reducing the likelihood that the treatment may need to be converted to the bigger incision while surgery is in process. Patients with chest wall abnormalities, for example, may not be excellent candidates for minimally invasive cardiac surgery because there may not be enough room in the chest cavity for the instruments to manoeuvre. MICS might also be complicated by underlying medical conditions such as vascular disease or lung illness. In some circumstances, the surgeon will do a sternotomy, which has remarkable benefits as well.

The technique utilised to repair the mitral valve is the same with both types of incisions, whether minimally invasive or classic sternotomy, and that gold-standard technique has proven to be effective.

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