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Minimally Invasive vs Sternotomy Recovery Time

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  • Minimally Invasive vs Sternotomy Recovery Time

    My surgeon plans on using a minimally invasive approach to replace my aortic valve. During my consultation he said they would make a 3 to 5 inch incision compared to a 6 to 8 inch incision for a full sternotomy. Do the recovery times really differ much between the two approaches? I'm not sure I'm asking this in the right forum.

    BAVD John
    BAVD John
    Northwestern Memorial, Chicago
    Dr. Patrick McCarthy, surgeon
    Carpentier-Edwards PERIMOUNT Magna Aortic Heart Valve 23mm, July 28,2009
    implant 24 days before my 54th birthday

  • #2
    I'm curious you are calling it minimally invasive. I've heard of mini-sternotomies, which it sounds like you are having,and I have heard of them going in between ribs on the right side of the chest and don't cut your sternum at all. I have read that if you have the side chest incision you can be back to "normal" within four weeks approximately. I am assuming if you have the mini-sternotomy the better for healing and less chance of an infection. Either way you have to be better off than a full sternotomy. Good luck.

    kris
    Valve sparing aortic root replacement
    Northwestern Hospital Chicago
    Dr. Chris Malaisrie--May 22, 2009

    Comment


    • #3
      kris,

      Well in the patient handbook I recieved from Northwestern they use the two terms I mentioned in my above post. It only makes sense to me that there should be less trauma to me with the mini-sternotomy as you call it as compared to the full sternotomy. I would think either way it takes a full six weeks for the chest to heal.

      How was your experience at Northwestern? McCarthy will be doing my surgery this Tuesday.

      BAVD John
      BAVD John
      Northwestern Memorial, Chicago
      Dr. Patrick McCarthy, surgeon
      Carpentier-Edwards PERIMOUNT Magna Aortic Heart Valve 23mm, July 28,2009
      implant 24 days before my 54th birthday

      Comment


      • #4
        Be delighted that you have the option of the smaller incision, be prepared for a much bigger reality. Sometimes even the best laid plans have a way of turning around on us.
        14 Mar 2000 AVR with Medtronic Stentless Freestyle Dr Dennis Modry, University of Alberta.
        20 Aug 2006 Medtronic Stentless Freestyle aortic valve and root Dr Dennis Modry

        Comment


        • #5
          Yep, I prepared for the larger incision as well. My cardic cathe results were good yesterday. However, I don't know the results of the MRI of my aorta that was done on this past Thursday. I did have a CT of my aorta last year and it was normal and my recent echo's have looked ok as well. With that being said the MRI will be the deciding factor if any work will need to me done on the aorta. I'm hoping for the best on the MRI results.

          BAVD John
          Surgery Tuesday, July 28, 2009
          Northwestern Memorial, Chicago
          Surgeon, Dr. Patrick McCarthy
          Edward Lifesciences Bovine valve, size to be determined.
          BAVD John
          Northwestern Memorial, Chicago
          Dr. Patrick McCarthy, surgeon
          Carpentier-Edwards PERIMOUNT Magna Aortic Heart Valve 23mm, July 28,2009
          implant 24 days before my 54th birthday

          Comment


          • #6
            John,

            With Dr. McCarthy I wouldn't worry he has a fantastic reputation. I don't have to tell you he started the Bluhm Institute in Chicago and when I told my cardiologist in Wisconsin I was thinking of going to Northwestern he immediately said "are you going to Dr. McCarthy he is excellent".

            I would assume with the mini-sternotomy you are still looking at 6-8 weeks for lifting restrictions. My surgeon told me he is comfortable after 6 weeks that you won't get an infection. I'm about nine weeks out and feel fantastic.

            Northwestern was a great experience. ICU nurses were wonderful (I work in a hospital and have high expectations) most nurses work 12 hour shifts so you should only have two nurses taking care of you every day. My ICU nurses stayed with me in my room the entire time I don't think they sat down once, a lot of activity as they are checking everything. You will wake up with three chest tubes, foley catheter, external pacing wires, central line/catheter in your neck, intubated, pain pump in your incision, I had a goin sheath, and an arterial line in my wrist ( I think I covered it) You will find over the course of the next two days most of these things will be removed as they get you up walking around. Within about three days you will probably have an echo in your room and a CT in the departmet with a chest x-ray. All of the rooms are private as you know. Make sure you ask for your pain meds if you need them I had a nurse that would mark on the dry erase board when I got my pain med and when I could have my next dose if I wanted it, others did not do this.

            Good luck you wil do well.

            Kris
            Valve sparing aortic root replacement
            Northwestern Hospital Chicago
            Dr. Chris Malaisrie--May 22, 2009

            Comment


            • #7
              kris,

              Thanks for the response. I'm glad I'll be asleep when they are putting all those tubes and things in me. I know it's time to get this done and I'm looking forward to getting to the other side of the mountain. I'll find out some time tomorrow what time my surgery is on Tuesday. I'm pretty sure it will be early in the morning.

              I hope I feel as good as you do in 9 weeks. I plan on fishing in Door County in October.

              Thanks again,

              BAVD John
              BAVD John
              Northwestern Memorial, Chicago
              Dr. Patrick McCarthy, surgeon
              Carpentier-Edwards PERIMOUNT Magna Aortic Heart Valve 23mm, July 28,2009
              implant 24 days before my 54th birthday

              Comment


              • #8
                John, the best to you as you have this surgery. This coming Wed. I will be 6 weeks
                post op. I had a MV replacement with an On-X valve. The surgeon did it though
                a 4-5 in. incision under my breast and went though the ribs. I could not be
                happier with his work, you can not even see the incision. I can't help but think
                that it might be a faster recovery as far as your incision healing, yet your body
                will go though all the same things that they do though the sternum. Just plan
                to give yourself time to heal and take it slow, everyone is different, but this
                forum is great for asking questions and sharing.

                Comment


                • #9
                  I had the AVR mini-invasive surgery down in Miami by Dr. Lamelas. Fantastic hands! I have had no complications whatsoever and its been six weeks. Never experienced any paid at all and never had to take my pain medication when I returned home. Was in the hospital for 4 days. This was six weeks ago. I am returning to work tomorrow. I couldnt be happier to have had the mini-invasive surgery. I was fully prepared for the full surgery.

                  Comment


                  • #10
                    Rmonteag,

                    Thanks for the information, it is appreciated. By the way two of my children attend U of I. I guess it will be wishful thinking on my part to watch my wife and other two children move them in on August 18.

                    BAVD John
                    BAVD John
                    Northwestern Memorial, Chicago
                    Dr. Patrick McCarthy, surgeon
                    Carpentier-Edwards PERIMOUNT Magna Aortic Heart Valve 23mm, July 28,2009
                    implant 24 days before my 54th birthday

                    Comment


                    • #11
                      Hi, John,

                      As a Chicagoan in The Waiting Room, I'll be watching for your progress reports and assessment of Northwestern. My cardio puts them high on the list of choices for my surgery, when that time comes.

                      Best of luck!
                      Go Class of 2011!

                      Steve Epstein
                      9 Years in The Waiting Room, then on February 28, 2011,
                      AVR with 23mm Edwards Bovine Pericardial Tissue Valve, Model 3300TFX, Pacemaker - Boston Scientific Altrua 60 DDDR IS-1 and CABG (LIMA-LAD) at Northwestern Memorial Hospital, Chicago by Dr. Patrick McCarthy and the most wonderful team of professionals I could ask for.

                      Comment


                      • #12
                        BAVD John and the others here,

                        I just wanted to let you know that if you check my profile, you'll see an album of pictures of what "extras" were attached to me post surgery. The forum scrambled the order of the album somewhat, but there's a series of pictures from about 2 days post surgery to about 2 weeks. It shows the chest tubes, the Swann-Gantz (sp?) catheter in my neck, the arterial line in my arm, the (in my case full) sternotomy incision, the pacing wires, and various instrumentation that was vital in monitoring me after surgery. This will give anyone interested in seeing what they will probably look like to loved ones post-surgery something to look at.
                        Yes, even the minimally invasive surgery will cause your body to react as if traumatized, so take things slowly and keep religiously to the lifting limitations. I know, I did, and still benefit from doing so.

                        Chris
                        [COLOR="Blue"][SIZE="2"]Emergency Repair of Flail Central Scallop Posterior Leaflet of Mitral Valve December 12th 2007[/SIZE][/COLOR]
                        [COLOR="DeepSkyBlue"]Two Chordae Tendineae Ruptured[/COLOR]
                        [COLOR="DarkGreen"]Carpentier Procedure, Dacron Annuloplasty Band, Model 4600, 32 mm[/COLOR]
                        [COLOR="Orange"][SIZE="2"]Dr. S. Scott Huerd, St. Lukes, Boise, ID[/SIZE][/COLOR]

                        Comment

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