Heart Valve Disease Treatment: Minimally Invasive Surgery
Joseph Zacharias is a Consultant Cardiothoracic Surgeon at Blackpool Victoria Hospital who specialises in Adult Cardiac and Thoracic Surgery. His surgical interests include Mitral Valve repair and Minimally Invasive Heart and Lung Surgery. Mr Zacharias has worked alongside Heart Valve Voice on many events and projects and is a big supporter of heart valve disease awareness. He is here to discuss treatment options for heart valve disease, more specifically, minimally invasive surgery.
In some of us, who are fortunate enough to age, one or more of our four heart valves that control the flow of blood can become worn, diseased or damaged leading to a diagnosis of heart valve disease. Heart valve disease can cause our valves to either leak, meaning the valve is failing to close properly therefore allowing blood to flow back through, known as regurgitation or become narrowed or calcified, in turn limiting the amount of blood allowed to flow through, known as stenosis. The most common forms of heart valve disease affect the aortic and mitral valves.
Patients diagnosed with heart valve disease may notice symptoms such as breathlessness, tiredness, tight chest and dizziness and as these symptoms worsen treatment will be required. The solution for heart valve disease can be either valve repair or replacement. Traditionally, the most commonly used treatment option was to perform surgery on the valves via the chest, called a sternotomy. This is when the surgeon divides the breastbone to gain access to the heart. This technique is useful when a wide exposure to the heart is required to perform the operation. However, this technique also comes with some disadvantages including a longer recovery, as long as two to three months, lifestyle limitations such as no driving or light lifting for up to six weeks and significant scarring, often leaving a 6 -9 inch scar on the chest.
Another and possibly less physically taxing treatment option for heart valve disease that is becoming more and more popular is the minimally invasive option. During the minimally invasive procedure, the heart is accessed through a 2 to 3 inch opening on the right side of the chest. To see the heart, the surgeon inserts a three dimensional, high-definition video camera into the chest and using specialised instruments they can then repair or replace the damaged valve. There are many benefits to minimally invasive surgery such as a shorter stay in hospital usually lasting four to five days, less discomfort post-procedure due to the small access point, less risk of developing an infection in the wound, less lifestyle limitations as recovery time is much quicker, and the patient will have a better cosmetic result.
It is easy to see why the minimally invasive technique is the more desired technique for valve disease surgery, but is it for everyone? While it is recommended that more complex valve repairs or those with co-morbidities such as previous lung surgery or patients with circulation problems may be best receiving a sternotomy, most mitral and aortic valve procedures can be done using the minimally invasive technique. Your surgeon will be the best person to decide the appropriate option for you.
Since 2008 I have performed in excess of 400 valve repairs and replacements using the minimally invasive technique. For many of my patients, this approach provides them with the option of getting back to their daily routine and favourite pastimes in much less time than the more invasive technique of a sternotomy. One of the most recent patients I have had the pleasure to be involved with is Norman Thorpe. At 92 years of age, he found himself slowing down due to heart valve disease. When he came to see me, it was apparent that he required treatment and as a very active and independent person it was an easy decision to provide him with the minimally invasive option. Norman’s surgery was on the 29 March and he was back living independently within a few weeks. He is now back in his garden trimming the hedges and mowing the lawn and back on his bicycle for regular rides. It is amazing to see how much of a difference the treatment has made in his life. It is not often that you are inspired by your patients but Norman inspired not just me but all the staff he came across with his attitude and approach to life.
This is why heart valve disease awareness is so important and why I fully support the work that Heart Valve Voice does. We need to make sure that people are aware of the disease and of the symptoms that accompany it so that we can get the right treatment to patients at the right time. With treatments like minimally invasive surgery, there are more options available to patients and this means that they have a better chance of getting their quality of life back quickly.
For more information about heart valve disease and treatment options visit the Heart Valve Voice website
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