Minimally invasive heart surgery - Less pain, more gain

Ask the expert: Dr. Alessandro Vivacqua, MD, a cardiothoracic surgeon with Corewell Health William Beaumont University Hospital in Royal Oak, shares his expertise on minimally invasive valve surgery.

Heart surgery is a well-established and safe treatment for heart valve diseases and blockages of the blood vessels that supply the heart with blood. Over the past several years, expert heart surgeons have looked for ways to gain the benefits of heart surgery without long incision and extended recovery periods. Minimally invasive valve surgery does just that by gaining access to the heart using less invasive methods. Minimally invasive valve surgery is used to repair or replace a malfunctioning aortic, mitral or tri-cuspid valve with an artificial one. Valves help blood flow normally through the heart’s four chambers and throughout the body.

Our Corewell Health team has a long track record of success with minimally invasive valve surgery techniques. At Corewell Health William Beaumont University Hospital in Royal Oak we began performing this procedure in 2000. Since then, the program has grown substantially. This minimally invasive approach is now the standard for all patients needing valve surgery.

Patients with tri-cuspid valve, mitral valve or aortic valve disease are candidates for MIVS. Only those who have had previous surgery in the right chest may not be eligible. Valve disease may present as stenosis (narrowing), causing the valve to not open fully to allow blood to exit the heart. Diseased valves may also regurgitate blood, meaning blood leaks back through the valve instead of moving out to the rest of the body. Symptoms of valve disease may include:

• Shortness of breath
• Fatigue
• Swelling in the legs
• Dizziness
• Chest pain
• Passing outUnpleasant awareness of your heartbeat

When evaluating options for surgery, you and your surgeon will decide what kind of valve works best for you -- either a biological valve or a mechanical valve. Biological valves are made mainly from pig, cow, or human heart tissue. They may not last as long as mechanical valves, but they have less risk of blood clots. Mechanical valves are man-made. Patients with mechanical valves need to take blood-thinning medicine for the rest of their lives because these valves increase the risk for blood clots. For patients experiencing mitral and tricuspid valve regurgitation, the valves are most often repaired instead of replaced.

The first question you should ask your surgeon is if he or she performs minimally invasive surgery. You should also ask what to expect in terms of pain, hospital stay, overall length of recovery. Patients can also ask how long minimally invasive surgery has been offered at the facility, and how many of these procedures the surgeon has completed. There is good evidence that the more experience the surgeon has, the better the outcomes.

For more information about Corewell Health’s minimally invasive valve surgery program, visit corewellhealth.org/heart-fp.