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Lorraineg57, July 18,  2019  7:39pm EST

Newb trying to decide between minimally invasive or sternotomy

Hi! Newbie here with MV repair/replacement on July 25th. My surgeon is giving me the choice of a sternotomy (assuming full) or the minimally invasive where they go in between the ribs. I originally thought “heck yeah” to the rib deal. That being said, I talked to his PA today and she said that although the decision is ultimately up to me, he prefers the sternotomy, for reasons of easier access/ visibility, etc.

She also said that there are a lot of nerves in the rib area so it can actually be more painful. 

I’m in excellent shape otherwise, no other health problems. Female, 62 yo, 5’5” 120 lbs. My heart is very strong, no blockages. I work out a lot, weights and heavy bag mostly so I was on board with the shorter recovery of a less invasive procedure, not to mention the aesthetic consideration. Asymptomatic at this  time but don’t see a point in waiting to see heart failure symptoms before acting.

Now I’m wavering. My surgeon is highly recommended and I know people come from other states to have him do their procedures.

Online all I see is promotion of the minimally invasive but most of the promotion is from hospitals or surgeons who are basically advertising. All I can think of is the huge scar my dad when he had bypass surgery 40 years ago...

Any or all input appreciated.

6 Replies
  • Catty350
    Catty350, July 18,  2019  8:22pm EST

    I had a mitral valve repair one year ago.  I was told the same thing about going through the ribs being more painful in recovery.  My surgeon also preferred doing the sternotomy which is what I went with.  My recovery was less painful than with some other surgeries I’ve had.  I also had minimal scaring.  I had to fly out of state for my surgery and 10 days post surgery I was feeling well enough to fly home (a 10 hour flight). I am so thankful to have had this surgery.  All of the symptoms of my leaky mitral valve have been eliminated. Healing wishes are being sent your way.  

  • Birdiecock
    Birdiecock, July 18,  2019  8:42pm EST

    I had minimally invasive on my mitral valve a year ago.  Both ways have pros and cons.  For me, the full sternotomy meant a longer time until I could play golf again.  I went to Duke and Dr. Glower did mine with the robot through the ribs, his preferred method.  My advice is that whichever way you go that you choose a surgeon who has done your chosen technique literally thousands of times.   Best wishes and keep us posted. 

  • NanaGwendy
    NanaGwendy, July 19,  2019  12:25am EST

    Hi. I’m 3 weeks post MV repair and LAD CABG. I’m 62 and in good shape, relatively asymptomatic before surgery. I didn’t really have a choice and had a full sternotomy. I will tell you that recovery has been very frustrating. It’s slooooow, and you don’t feel great. Having a shorter recovery with the same outcome would have been a blessing. 

    As I didn’t feel bad before the surgery, the recovery has been tough. You may have more patience than I do. Oh, the scar is not the scar of 20 years ago.  That part will be fine.

    Just my 2 cents. 

  • Sksorensen
    Sksorensen, July 19,  2019  12:36am EST

    I had a mitral valve repair in June 2018 via sternotomy. My surgeon said the bypass time would be half as long and that there there was less risk of damage to blood vessels with the bypass tubes right at the heart.    There was no question in my mind after that conversation that I wanted the sternotomy approach.  Sternal precautions for 8 weeks was a bother but a year later my scar is barely visible and a daily reminder to be grateful that my heart is fixed and that I can live the rest of my life without heart disease or complications from surgery.  

  • TRabb
    TRabb, July 19,  2019  9:04am EST

    I had a BAV replacement 3 weeks ago with a full sternotomy.  I'm almost 56 and in very good health.  My scar is healing quite nicely. I think of my scar as a reminder that I am still alive.  I might not be if I had waited too much longer.  I've not had much pain (didn't take any pain meds) and was able to sleep in my bed after a week.  That was very important since I'm a side sleeper.  I agree with the PA about exposure to the heart making the surgery better.  Also, if that is the surgeon preference and what he's used to and likes, why mess that up and take him out of his comfort zone?  That is never a good idea.  Good luck to you with whatever your choice is.  

  • Lorraineg57
    Lorraineg57, July 19,  2019  10:31am EST

    Thanks for all the prompt replies.

    Birdiecock, my reasons for preferring a minimal recovery are similar. I lift and use a heavy bag regularly at the gym and it's going to drive me crazy to be mostly sedentary for the recovery time. I'll be doing a lot of porch sitting for a while I guess.

    Sksorensen, thank you so much for that info. I was sure there had to be reasons to NOT prefer the minimally invasive route but was hard pressed to find that info online.

    NanaGwendy, ehhh.....I'll be hard pressed to be patient when I'm inactive. I know it will be slow going which is part of the reason I wanted to do this while it's summer here in PA. I didn't want to be stuck with a long recovery in the winter here when it's gray, dreary and frankly, depressing...I've seen pictures online that looked like the surgeon used a chainsaw.....scary....

    TRabb, thanks for that input. I had also wondered about sleeping since I'm also a side sleeper. My surgeon I'm sure is well versed in both approaches but if he prefers sternotomy, that may be the way to go.

    Again, thank you so much for all the replies. I think my biggest concern is ending up in worse condition. The internet (like this site) can be a tremendous resource but you also see many stories unfortunately with not optimal outcomes, which is scary. Thanks also for the encouragement.

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