Aortic replacement--minimally invasive vs standard

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Dr Gabrial Aldea at UWMC Seattle just consulted me that he would do the standard as opposed to minimally invasive which he's also well versed on. Is this because it's an aortic replacement and he needs to room? He said the difference was mostly cosmetic?

charlie
 
Hi Charlie - you'll have to quiz your surgeon himself for the reason why he wants to do standard instead of minimally invasive for you. Usually for aortic valve replacement without other work they do "minimally invasive". But what minimally invasive means to one surgeon means another thing to another surgeon, as I found out. "Minimally invasive" can mean an incision as small as two inches in length. Mine is four and a half inches in length and starts near the top of my sternum.. My sternum is six inches long so most of it has been cut....but it's still called "minimally invasive" !

Here's a funny anecdote - a physiotherapist at the hospital where I had my surgery told me that "minimally invasive aortic valve replacement", which is appreviated "mini AVR", meant I was going to get a mini aortic valve 'doh' !
 
Hi, I got my relatively new aortic valve on 1/16/14, a day that shall live in infamy, at least for me. I think it might be nice to be able to walk, or remember things, or not have the kind of personality changes I've gone through. I'm angry all the time. I don't want to be but since I was TAVR'd I've undergone too many changes. Last night I listed them and stopped at 16. I seem to be unable to love my incontinence thanks to my daily diuretic...such are the consequences of my procedure. I really shouldn't complain because after all I'm still alive...it's just too bad that I feel so bad. I think I preferred how I felt 20 years ago when they cracked me open and CABG'd me. I seemed to have recovered fairly rapidly...but this latest and greatest procedure has left me questioning my gullibility, that is faith in this surgical procedure: I think I was a practice dummy. AT least I have learned a new term, "pump head" I think I've a case of it and wonder if I'll ever feel better.
 
I can only tell you my experience, as everyone else has good and bad stories. I'm coming on 6 weeks post surgery. It was in my initial meeting with the surgeon I had chosen, when he told me that he only does the full open chest, and that I wanted a less evasive one, that he could refer me to doctors that do them.

I chose to stay with him based on his explanation as to why he prefers one over the other. First he said, that the healing process and pain is no more or less. the second reason was that he wants full access to my heart so he can see everything going on and work more freely.

As far as my healing, I can tell you that I never went beyond level four for chest pain, and I was off all pain med's in a week and a half. I think the biggest question you should be asking, is who is the best surgeon to work on your heart, and don't sweat the small stuff.

Good luck to you, and feel free to drop ANY questions my way about any of this. It's still VERY fresh in my mind, hahaha!!!

Take care,
Broncorod
 
I can only tell you my experience, as everyone else has good and bad stories. I'm coming on 6 weeks post surgery. It was in my initial meeting with the surgeon I had chosen, when he told me that he only does the full open chest, and that I wanted a less evasive one, that he could refer me to doctors that do them.

I chose to stay with him based on his explanation as to why he prefers one over the other. First he said, that the healing process and pain is no more or less. the second reason was that he wants full access to my heart so he can see everything going on and work more freely. And the main reason I chose him, was because everyone I spoke to in the medical field, said he was the best in our state.

As far as my healing, I can tell you that I never went beyond level four for chest pain, and I was off all pain med's in a week and a half. I think the biggest question you should be asking, is who is the best surgeon to work on your heart, and don't sweat the small stuff.

Good luck to you, and feel free to drop ANY questions my way about any of this. It's still VERY fresh in my mind, hahaha!!!

Take care,
Broncorod
 
I can only tell you my experience, as everyone else has good and bad stories. I'm coming on 6 weeks post surgery. It was in my initial meeting with the surgeon I had chosen, when he told me that he only does the full open chest, and that I wanted a less evasive one, that he could refer me to doctors that do them.

I chose to stay with him based on his explanation as to why he prefers one over the other. First he said, that the healing process and pain is no more or less. the second reason was that he wants full access to my heart so he can see everything going on and work more freely. And the main reason I chose him, was because everyone I spoke to in the medical field, said he was the best in our state.

As far as my healing, I can tell you that I never went beyond level four for chest pain, and I was off all pain med's in a week and a half. I think the biggest question you should be asking, is who is the best surgeon to work on your heart, and don't sweat the small stuff.

Good luck to you, and feel free to drop ANY questions my way about any of this. It's still VERY fresh in my mind,

Take care,
Broncorod
 
Sorry, I don't know why or how it posted my response 3 times. Tried to add an additional sentence. Just read #7.
 
My experience was much like Broncorod's. When I interviewed my surgeon, he told me that although he has done both standard and minimally invasive surgeries, his preference was the full sternotomy so that he has best access to the heart and can see all around it. As things progressed, I found that we would also be doing a bypass, which then required a full sternotomy. When I discussed this with my surgeon, he said that he would cut through my entire sternum but would keep the surface incision as small as possible to minimize scarring. He was/is as good as his word. Although I had a full median sternotomy, my incision is only about 4 inches long, and runs slightly at an angle with the top off-center. This way, if I'm wearing an open-collared shirt during the summer, my scar doesn't show.

This surgeon (see my signature line) was so good, as were his teammates, that had I not needed a pacemaker, at 3 1/2 years out, my scars are nearly invisible. The only really visible reminder of my heart journey is the lump made by my pacemaker.

So, the recovery is pretty much the same. If your surgeon can make you comfortable regarding how much or how little scarring you can expect, why not pick your surgeon and let him/her pick the approach to be used.
 
Thanks everyone and I hope ferguson is doing and will be doing better, I'm sure you weren't a "practice dummy" but it may seem that way as to your current feeling so please keep us posted since your TAVR is a fairly new procedure and your experiences are important here...all the best mate!

To the rest..after thinking and rereading your replies..I agree that whatever the surgeon wants and is comfortable with is exactly what I should be concerned about.
 
Hi Charlie, my surgeon said he would do a minimally invasive procedure and the scar would be lower so I could wear a v-neck without it showing. When I woke up, I had a full sternotomy with a 6" scar. I was mildly annoyed, but I figure if the extra room means he was able to do a better job it was well worth it. Recovery wasn't bad.
 
Hi Charlie, my surgeon said he would do a minimally invasive procedure and the scar would be lower so I could wear a v-neck without it showing. When I woke up, I had a full sternotomy with a 6" scar. I was mildly annoyed, but I figure if the extra room means he was able to do a better job it was well worth it. Recovery wasn't bad.
 
just an update to this thread. I learned here you don't try and change a surgeons technique, :)

I'm lucky so far in that I've had time to hone down surgeons who do the minimally invasive aortic valve replacement so I wanted to qualify for what seems a much less trauma minimally invasive approach mainly because Cleveland Clinic and and a few other well respected *valve shops* are now doing. Question..should I be at all concerned I've selected a 60> yo surgeon for this (lars svensson md)

happy holidays is mandatory here :)
 
just an update to this thread. I learned here you don't try and change a surgeons technique, :)

I'm lucky so far in that I've had time to hone down surgeons who do the minimally invasive aortic valve replacement so I wanted to qualify for what seems a much less trauma minimally invasive approach mainly because Cleveland Clinic and and a few other well respected *valve shops* are now doing. Question..should I be at all concerned I've selected a 60> yo surgeon for this (lars svensson md)

happy holidays is mandatory here :)
 
just an update to this thread. I learned here you don't try and change a surgeons technique, :)

I'm lucky so far in that I've had time to hone down surgeons who do the minimally invasive aortic valve replacement so I wanted to qualify for what seems a much less trauma minimally invasive approach mainly because Cleveland Clinic and and a few other well respected *valve shops* are now doing. Question..should I be at all concerned I've selected a 60> yo surgeon for this (lars svensson md)

happy holidays is mandatory here :)
 
just an update to this thread. I learned here you don't try and change a surgeons technique, :)

I'm lucky so far in that I've had time to hone down surgeons who do the minimally invasive aortic valve replacement so I wanted to qualify for what seems a much less trauma minimally invasive approach mainly because Cleveland Clinic and and a few other well respected *valve shops* are now doing.

Question..should I be at all concerned I've selected a 60> yo surgeon for this (lars svensson md)

happy holidays is mandatory here :)
 
I'm lucky so far in that I've had time to hone down surgeons who do the minimally invasive aortic valve replacement so I wanted to qualify for what seems a much less trauma minimally invasive approach mainly because Cleveland Clinic and and a few other well respected *valve shops* are now doing.

Question..should I be at all concerned I've selected a 60> yo surgeon for this (lars svensson md)

happy holidays!
 
I'm lucky so far in that I've had time to hone down surgeons who do the minimally invasive aortic valve replacement so I wanted to qualify for what seems a much less trauma minimally invasive approach mainly because Cleveland Clinic and and a few other well respected *valve shops* are now doing.

Question..should I be at all concerned I've selected a 60> yo surgeon for this (lars svensson md)

happy holidays!
 
As for a 60 yo surgeon, I many cases, I would be concerned. However, I am very biased towards the CCF. I believe the surgeons there are among the best. They are so because they keep up with new and better ways of performing surgery. If you told me it was a general surgeon who was 60, I would be concerned that he may not be up to date..
 
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