Written with A. Marc Gillinov, M.D. and Tomislav Mihaljevic, M.D.
What is minimally invasive mitral valve repair surgery?
With more than 3000 minimally invasive procedures completed, Cleveland Clinic has the nation's largest experience with minimally invasive mitral valve repair surgery. Employing state-of-the-art techniques, today minimally invasive valve surgeries account for 87 percent of the minimally invasive cardiac surgeries performed at Cleveland Clinic.
Minimally invasive mitral valve repair surgery is performed through a small incision, often using specialized surgical instruments. The incision is 2- to 4-inches instead of the 6- to 8-inch incision required for traditional surgery. Robotically assisted keyhole approaches or port-access techniques are also available for some types of surgery.
Cleveland Clinic offers full range of minimally invasive mitral valve surgery approaches
Cleveland Clinic heart surgeons have expertise with the full range of minimally invasive approaches for mitral valve repair, enabling us to offer individualized treatment for each patient. These minimally invasive valve procedures, which range from a 2- to 4-inch incision to fully endoscopic surgery, include:
Traditional heart surgery incision The incision is larger (about 6 - 8 inches), made down the sternum, through bone and muscle
Benefits of minimally invasive mitral valve surgery
The benefits of minimally invasive mitral valve surgery may include:
- Reduced pain
- Reduced blood loss
- Reduced risk of infection
- Shorter hospital stay
- Faster recovery
- Faster return to work
- Less scarring, improved appearance after surgery
The right mini-thoracotomy is performed with a 2- to 3-inch skin incision created in a skin fold on the right chest, providing an excellent cosmetic result.
The heart is approached between the ribs, providing the surgeon access to the mitral valve. There is no sternal incision or spreading of the ribs required for this surgical technique.The surgeon inserts special surgical instruments through the incision to perform the valve repair. Results with this approach are excellent
Partial Upper Sternotomy
A partial upper sternotomy includes a 2- to 3-inch skin incision and division of the upper portion of the sternum, providing the surgeon access to the mitral valve to perform the repair. In contrast, a traditional sternotomy requires an 8- to 10 -inch incision down the entire sternum.
The partial upper sternotomy offers the surgeon an excellent view of the mitral valve and may be an appropriate approach for patients who require combined mitral valve and aortic valve procedures.
Robotically-Assisted Mitral Valve Repair
Robotically assisted mitral valve surgery is a type of minimally invasive surgery in which the surgeon uses a specially-designed computer console to control surgical instruments on thin robotic arms. The robotic arms are introduced through a 1- to 2-cm incision in the right side of the chest. The surgeon's hands control the movement and placement of the endoscopic instruments to open the pericardium (thin sac that surrounds the heart) and to perform the procedure.
Robotically assisted mitral valve surgery provides the surgeon with an undistorted, three-dimensional view of the mitral valve, leaflets and subvalvular structures with the use of special camera. This approach enables surgeons to perform complex repairs without the need for division of the breast bone (sternum) or spreading of the ribs, in most cases.
Robotically Assisted Incision
If you would like to find out if you are a candidate for minimally invasive mitral valve surgery or learn more about minimally invasive heart surgery, contact us or call the Miller Family Heart & Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.