Minimally invasive heart procedures: What you should know

An estimated five million Americans are diagnosed with heart valve disease each year, according to the American Heart Association.

Issues with the heart valve often require corrective surgery. Dr. Joseph Lamelas, associate chief of cardiac surgery at Baylor College of Medicine, says minimally invasive heart valve surgery may be the right option for you.

Symptoms of valve disease

Lamelas says you can have either valve stenosis or leakage and not know anything is wrong until the condition has become severe.

“The valves of the heart function like doors. They have to open and shut completely during each cardiac cycle. Once they develop problems, they need to be fixed,” he said.

Signs of valve stenosis or leakage include:

• Chest pain
• Fainting
• Shortness of breath
• Lightheadedness
• Heart murmur
• Fatigue

Lamelas emphasized that if left untreated, valve issues can lead to enlargement of the heart chambers and worsening heart function.

Minimally invasive procedures

In the past, aortic or mitral valve replacement surgery was performed by opening the patient’s chest through their sternum.

“Surgeons have developed techniques that partially open the sternum to get access to the heart. However, in my mind, this is still opening the sternum, which is not a less invasive operation. No one really wants their chest split open,” Lamelas said.

To avoid opening the chest, a minimally invasive approach known as mini-thoracotomy can be performed. This is achieved by opening the chest through small incisions on the side.

“The minimally invasive aortic valve operation is a five centimeter incision. The entire operation is performed through this tiny port,” he said.

Benefits of minimally invasive surgery

Lamelas noted that the benefits of receiving minimally invasive heart valve surgery include:

• Reduction of surgical trauma
• Decrease in complications
• Blood loss reduction
• Less pain
• Decrease in post-operative recovery time

An echocardiogram is normally performed to determine which valve is affected and thereafter plan the procedure that would be most appropriate.

“When you have aortic valve stenosis, we’ll do an echocardiogram to evaluate the degree of stenosis. When aortic valve stenosis becomes severe, the valve must almost always be replaced rather than repaired,” Lamelas said. “On the other hand, the majority of patients with mitral regurgitation will undergo valve repair surgery. This operation combines science and art. It is equivalent to performing plastic surgery on the mitral valve.”

Lamelas says he has encountered few patients who are not qualified for the minimally invasive approach.

“Some patients who don’t have symptoms and have severe valve pathology and should have the operation to improve their long term survival. Minimally invasive surgery has a positive psychosocial impact and patients do get back to their normal lifestyle relatively quickly,” he said.

Additional Resources

To schedule a visit with a Baylor cardiothoracic surgeon, request an appointment online.

Learn more about American Heart Month.

-By Nicole Blanton