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I see your point and I agree on one thing. Do not push a surgeon out of his comfort zone. When you are looking into specific minimally invasive approaches you quickly reach a fork in your decision making. You either accept the anyway excellent results of a traditional sternotomy operation by the...

A miniAVR can be performed with either a mechanical or biological valve using identical techniques. A good percentage of AVR patients are somewhat overweight but that it is not an issue that affects their candidacy for a minimally invasive approach. They can almost always get a minithoracotomy...

My best wishes to you, Lisa. Who knows...maybe a magic wand will be available Heartdoc

It is possible to have a broken wire years after surgery as the sternal bone remodels itself. Most of the times it is of no consequence. If it does not bother you and it is not sticking out, there is most likely no need to do anything about it. It is certainly worth a call to your surgeons to...

Hi, I know what you mean. It must be a tough transition for you. Many patients develop a wonderful trusting relationship with their surgeon. I often get calls even for health issues and decisions unrelated to the heart and I am happy to have this relationship with my patients. If no surgery is...

The threshold measurements for surgery on an ascending aortic aneurysm are generally applicable across the board (yes..including the "yocal local surgeon"). Most cardiac surgeons had excellent training and can carry out an ascending aortic aneurysm repair with good results and an overall risk...

Duff Man, The timing of surgery has to do with both the size of the aneurysm and the degree of malfunction of the BAV. Patients with BAV are more at risk for aneurysm complications than patients with normal aortic valves and that's why the size threshold for intervention is in the range you...

Queen, I can imagine the anxiety these echo readings provoked. The best thing to do is to discuss these results in detail with your cardiologist as soon as possible. I suspect they would have not sent you home if there was anything that granted intervention but you need to get your answers. Do...

Carole, The drugs they prescribed are effective and safe in helping patients with decreased ejection fraction and might also help if you have mitral regurgitation. Don't forget to ask your doctors about the degree of severity of the "leak around the valve" (AKA perivalvular leak). In some cases...

Hi Lyn, That is correct. Muscle tissue has an excellent blood supply that can deliver more oxygen and help in healing and clearing infections from a debrided sternum. I'll search my files and see if I can find a copy of a normal MRI. I'll keep you posted. Best, Heartdoc...

Radiation therapy can compromise the quality of blood supply to the sternum by literally "burning" small and medium sized arteries that normally feed the bone. The mammary arteries are often used for coronary artery bypass grafting and once they are harvested they no longer contribute to the...

Hi Kathy, A ministernotomy approach can also be described as minimally invasive heart surgery In cardiac surgery there is a broad definition of what we mean by "minimally invasive". There are basically two types of "invasions": 1) Surgical incision: if they are smaller than a full sternotomy...

Hi, Ascending aortic surgery can be performed through an upper ministernotomy. If the surgery also has to address the entire aortic arch, a full sternotomy will be necessary to have proper exposure and perform a complete arch repair Heartdoc www.bigappleheartsurgery.com

Radiation damage to the heart Radiation damage to the heart Hi Al, Yes, I have seen a number of patients with radiation damage to their hearts. The vast majority had a history of mediastinal Hodgkins treated with high dose radiotherapy. The radiotherapy chest field affects more often the...

Hello Mike, I'm glad to hear you had a great outcome with your minimally invasive surgery. I'm sure your comments will help others feel comfortable with choosing their type of surgery. Wishing you a smooth and continued recovery, HeartDoc www.bigappleheartsurgery.com

Thank you Hank, I am glad to be part of this community. Best, HeartDoc www.bigappleheartsurgery.com

I agree with you on the fact that you might have dealt with a regional bias. Only expert minimally invasive heart surgeons with extensive experience in both sternotomies and minithoracotomies can really make a fair comparison between the different surgical approaches. In expert hands that have...

Hello Andycap, I'm sorry to hear your father had all these problems. If the hemolysis is severe after the percutaneous transcatheter obliteration and he is more symptomatic he would be better off with an early reoperation to eliminate the PVL once for all. He is still young and should be...

Thank you for bringing this recent Brazilian article up. It was published earlier this month and I have included it in one of my Grand Rounds lectures on bloodless heart surgery. It stresses a very important point. Too many hospital use a "liberal" transfusion policy in heart surgery patients...

Lyn, Good point! True: each person can have slight differences in the heart anatomy. In minimally invasive procedures carried out through an incision underneath the right breast (4th intercostal space) I might opt to make a small incision in the skin crease of the right groin to insert one...