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Minimal invasive vs open heart
Brand new. 63 years young living in Tucson. 2 days ago, an ETT and Cardio cath have confirmed no blockage but severe MVR. No real symptoms. My original cardio suggested an open heart surgery for repair. Then I started to get educated. Looks like minimal invasive should be my FIRST option. But need to have it done 2 hours away at the Mayo Clinic in Scottsdale. I meet with them for the 1st time Monday morning.
Looking for your thoughts on which procedure?
What questions should I be asking the folks at Mayo?
PS If this has been discussed before, please send me the links.
AmbassadorDN, January 31, 2019 12:42pm EST
Hi, Scott, and welcome!
I'm sure others will be along shortly to offer their insights into heart valve surgery; however, I have had both minimally invasive and open-heart, though my open-heart surgery was a "mini-sternotomy."
Minimally invasive heart valve surgery, when possible, is the way to go (in my honest opinion). Still, my second minimally-invasive surgery was much harder to recover from than the first. One great benefit of minimally-invasive surgery is that there is often a much quicker recovery involved--about 4-6 weeks.
Here is one link from the AHA to get you started: https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/newer-heart-valve-surgery-options
Know that we are all here for you so feel free to ask away!
Wishing you the best as you anticipate surgery!
To Heart and Soul Health,
AmbassadorDN, January 31, 2019 12:44pm EST
Here is a link from my fellow Ambassador Christine of questions to ask your surgeon: https://supportnetwork.heart.org/blog-news/christine-rekash-questions-i-asked-before-heart-surgery/
Gocolts, February 1, 2019 8:27pm EST
Thank you Ambassador DN and Christine!
Christine, I found your 2/28/17 reply telling your story. You indicated that you opted for open heart instead of minimal invasive. May I ask why? And if you feel those reasons are still mostly valid?
Being a newbie, and not getting many replies, is there another MVR forum to seek advice from those that have been thru this?
Also, anyone have any way/suggestion as to speak via the phone with a minimal invasive doc at Cleveland Clinic?
AmbassadorMR, February 2, 2019 11:12am EST
The choice of surgical procedure involves much more than can be fully addressed in this forum. Having said that, I'm pleased that you are going to the Mayo Scottsdale Clinic for a workup. I had a minimally invasive aortic valve replacement procedure at Cleveland Clinic in 2012 and like AmbassadorDN, the pain wasn't necessarily less but the recovery time is generally shorter than a full incision sternotomy.
It really comes down to the training and expertise of the surgeon and his/her team when assessing outcomes. I strongly encourage you to educate yourself as much as possible regarding the pros and cons of the various prodecures for addressing your severe MVR. These conditions are very treatable and the vast majority of us as patients experience an excellent long-term outcome. Don't hesitate to ask tough questions of your surgeon and cardiologist. Specifically, how many procedures has the surgeon performed, what are his/her complication rates and what are the outcome data for the surgeon and the hospital where you choose to have your procedure.
Let us know if we can be of additional help to you as you navigate the process for your upcoming treatment. It is daunting at times but the payoff comes in the chance to return to a normal and active life again. All the best to you in your heart health journey.
AmbassadorC, February 3, 2019 7:18am EST
Both my fellow Ambassadors provided great insight re the two different procedures. I also see that there was a link posted re the questions I asked of my surgeon. My first suggestion would be to take these with you and discuss your options with the surgeon. I echo Ambassador MR remarks re the experience of the surgeon combined with what is best for your situation. For me personally, I was cautioned, that there was a chance upon the operation commencing with the minimally invasive procedure, that if they couldn’t repair the valve and found out that there was more work to be done once they “were in there” then they would have to process with open heart. For me, that would be my luck and then I would have to deal with the entry point under my ribs and the OHS incision. Thus, I chose OHS. That may even be a question you want to add to the list.
Best wishes tomorrow as you recieve your consult. Please let us know how it all goes. We welcome you with heart. ❤️
ES1960, February 4, 2019 10:13pm EST
I'm 58 & I've had both the minimally invasive surgery and the traditional sternotomy. The minimally invasive surgery was performed in March, 2015 to repair my mitral valve. It was done by a very reputable surgeon. Six weeks after the surgery an echocardiogram revealed that the surgery didn't work - my mitral valve still had severe regurgitation. I had the traditional sternotomy in August, 2016 at Columbia Presbyterian in NY, with a different surgeon, who replaced my mitral valve with a mechanical valve. Everything is working very well now. To compare the two - both were 6 hour surgeries with 90 minutes or so spent on bypass. I had chest tubes and pacing wires after each surgery. I spent 2 days longer in the hospital after the minmally invasive surgery because my right lung, which was collapsed during the operation to allow access to the heart, wouldn't fully inflate. The only truly painful part of either surgery was the removal of one of the chest tubes after the minmally invasive surgery (just for a few seconds). A nerve in my right arm was affected after the minimally invasive surgery which has nominally altered my range of motion to this day, and for a few weeks after that surgery I experienced right shoulder pain. There was really no benefit to me having the minimally invasive surgery - if anything I had more issues after that surgery than the sternotomy. Pain, other than the few seconds I described earlier, was not a factor in either surgery, nor was the recovery period. I was very physically fit prior to each surgery so I was able to go back to work relatively quickly after each operation & eventually go back to my intense workouts and get back in the same shape as before my surgeries. I was asymptomatic before each one - my yearly echo discovered an enlarged left atrium & ventricle making it necessary to get the valve repaired - so I was able to workout right up until each operation. This is just one person's experience. I wish you the best of luck with whichever type of surgery you choose.
MurphyDad, February 22, 2019 1:56pm EST
Hi Scott. I hope you are progressing in a positive manner. 68 years oId here. I too am in Tucson and just received word that I need an Aortic valve replacement (Bicuspid valve and stenosis). Just researching my options now. I am wondering why you chose to go to Mayo in Scottsdale instead of staying here in Tucson as I am considering the same plan. Did you have to see a cardiologist there? Or were you referred by one here in town? My hope is for the TAVR procedure but afraid they will think I am not a high enough risk patient to qualify. Any thoughts or feedback would be greatly appreciated. I hope you have a rapid recovery and great success.