If you or a loved one has suffered from valve disease or blockages in the coronary arteries, then you know the procedure traditionally performed is an open heart surgery. The mechanics behind the surgery—a median sternotomy is typically required—are just what you’d imagine: first, the sternum is divided and spread apart so the surgeon can visualize the heart, then the physician performs the surgery.
As you might suspect, there are disadvantages to this type of surgery, including additional time in the hospital, an extended recovery, and a significant scar on the chest (it’s often called a ‘zipper’ due to its resemblance). It’s no surprise, then, that cardiac surgeons and cardiologists have been developing and implementing less invasive options for patients. One example is minimally invasive valve surgery performed by Lankenau Heart Institute physicians.
According to Sandra V. Abramson, MD, a non-invasive cardiologist at Lankenau Medical Center, “Minimally invasive surgery is performed through several small incisions in the chest and groin rather than one large (6-8 inches) one. This approach is beneficial because, as Dr. Abramson explains, smaller incisions cause less pain, and allow patients to recover quicker and return to work and daily activities sooner.
Of course, if you don’t have a medical background, you might not be sure if this surgical alternative is an option for you or a loved one. But, Dr. Abramson says that most heart procedures do, in fact, have a less invasive option. And, thanks to newer technology and smaller devices, these minimally invasive options are now available to a larger number of patients, too. Specifically, she mentions: “For aortic valve surgery, there are several options, including open heart surgery, minimally invasive surgery or transcatheter aortic valve replacement (TAVR).” .
Unfortunately, just because the alternatives exist doesn’t mean every physician is trained in or comfortable performing these types of procedures. Dr. Abramson suggests, “Patients should ask their doctors if there is a less-invasive option available and do research on their own.” If their doctor is not familiar with minimally invasive or transcatheter options, she says, “Patients should be comfortable asking for a second opinion—especially when it comes to [their] heart.”
Luckily, there are medical facilities that specialize in these minimally invasive surgeries. In the Philadelphia region, the team at Lankenau Medical Center performs the highest volume of minimally invasive surgeries with outcomes that exceed national averages. The Lankenau Medical Center team is continually at the forefront of leading surgical advancements, and they’re about to participate in the first study to perform transcatheter aortic valve replacement (TAVR) on low-risk patients. Additionally, Lankenau’s rates for minimally invasive mitral valve repair far exceed the national average. Eighty one percent of mitral valves are repaired at Lankenau using minimally invasive techniques, compared to 57 percent nationally. This technique, developed by Lankenau cardiac surgeon Scott Goldman, MD, requires only a two-inch incision, and two port sites of less than ¼ inch.
For now, not all heart procedures have minimally invasive alternatives, and some still necessitate the larger incisions. What patients and their loved ones should know, however, is that for some surgeries, the alternatives do exist, and they should discover if it’s an option for them. “[It’s important that] patients become their own advocates,” says Dr. Abramson.
For more information about women’s heart disease and cardiac health risks, visit Lankenau Heart Institute here.
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