Minimally Invasive Mitral Valve Repair

Overview

What is minimally invasive mitral valve repair surgery?

Traditional heart surgery incision The incision is larger (about 6 - 8 inches), made down the sternum, through bone and muscle

With more than 3500 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:

Right Mini-Thoracotomy

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.

Right Mini-Thoracotomy

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.

Partial Upper Sternotomy

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 inch 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.

Mitral Valve Repair

Resources

Doctors who treat

Cleveland Clinic has the nation's largest valve treatment program.

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Surgeons

The following Mitral Valve Center surgeons specialize in mitral valve surgery:

The Mitral Valve Center surgeons offers expertise and experience to provide the best outcomes possible.

The Miller Family Heart, Vascular & Thoracic Institute offers specialty centers and clinics for patients whose treatment requires the expertise of a group of doctors and surgeons who focus on valve disease:

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, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

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Last reviewed by a Cleveland Clinic medical professional on 07/19/2019.

References

  • Gillinov M, Mihaljevic T. The Future of Mitral Valve Surgery. Tex Heart Inst J. 2012; 39(6):840–841.
  • Iribarne A, Easterwood R, Chan EYH, Yang J, Soni L, Russo MJ, Smith CR, Argenziano M. The golden age of minimally invasive cardiothoracic surgery: current and future perspectives. Future Cardiol. 2011 May; 7(3):333–346.
  • Johnston DR, Roselli EE. Minimally invasive aortic valve surgery: Cleveland Clinic experience. Ann Cardiothorac Surg 2015;4(2):140-147 :
  • Malaisrie SC, Barnhart GR, Farivar RS, Mehall J, Hummel B, Rodriguez E, Anderson M, Lewis C, Hargrove C, Ailawadi G, Goldman S, Khan J, Moront M, Grossi E, Roselli EE, Agnihotri A, Mack MJ, Smith JM, Thourani VH, Duhay FG, Kocis MT, Ryan WH. Current era minimally invasive aortic valve replacement: techniques and practice. J Thorac Cardiovasc Surg. 2014 Jan;147(1):6-14. Epub 2013 Nov 1.
  • Mihaljevic T, Koprivanac M, Kelava M, Avi Goodman A, Jarrett C, Williams SJ, Gillinov AM, Bajwa G, Mick SL, Bonatti J, Blackstone EH. Value of robotically assisted surgery for mitral valve disease. JAMA Surg. 2014 July; 149(7): 679-686.
  • Secchin Canale L, Mick S, Mihaljevic T, Nair R, Bonatti J. Robotically assisted totally endoscopic coronary artery bypass surgery. J Thorac Dis. 2013 November; 5(Suppl 6): S641–S649.
  • Society of Thoracic Surgeons

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy