The traditional approach to mitral valve surgery has been through the sternum or breast bone. At least 90% of all mitral valve repairs are performed this way. In patients needing only mitral valve repair, it is possible to approach the operation “minimally invasively”. At most hospitals this means a smaller sternotomy – with this approach up to 80% of the breast bones are still divided.

At CTS we prefer to approach surgeries performed for only mitral valve operations, through a right chest approach and avoid opening the breast bone entirely. Mitral valve replacements (which are much less common than repairs) are performed through a 2 inch incision just below the right breast and a small 1 ½ inch groin incision.

The advantages of this approach are:

• Decreased recovery time – 2 weeks to return to normal activities or work vs. 2 months for a sternotomy (opening of the breast bone)
• Decreased blood loss – fewer transfusions vs sternotomy operations
• Decreased risk of wound infection
• Improved cosmesis – a woman can easily hide her small scar with her bikini or bra (photo)

Most patients needing mitral valve surgery are candidates for mitral valve repair. Mitral valve repair is favored over replacement because short (30 day), intermediate (up to 5 years) and long term (over 5 years) outcomes (including death and reoperation rate) are better with repair as opposed to replacement. Most valves that leak can be fixed if your operation is performed at a facility skilled in repair techniques. At CTS we have an active mitral valve repair practice and we do more than 150 mitral valve repairs each year.

We prefer to repair mitral valves that leak with the daVinci robot when possible. Patients needing repair only are usually good candidates. With a Robotic Mitral Valve Repair, 5 small incisions (4- 1 cm incisions and 1- 2 cm incision) are made in the right chest around the breast and a 1 ½ inch groin incision is made as well. The heart portion of the operation is identical to that done through the breast bone and all repair techniques are available and used.

The advantages of robotic mitral valve repair are the following:

• Improved repair rates – our mitral valve repair rates for isolated mitral leakage (insufficiency) exceed 95%. Nation wide repair rates are near 50%.
• Faster recovery – You typically return to work and/or normal activities in 2 weeks after your operation vs. 2 months for a sternotomy.
• Less bleeding – fewer transfusions
• Fewer infections
• Surgery cosmesis – a woman can easily hide her small scar with her bikini or bra

If you need a mitral valve repair and would like to know if you are a candidate for minimally invasive robotic surgery, email or call us at 205.716.6900.