Minimally invasive for BAV?

[tomflies1]

I received the results of my angiogram today, pretty much what I expected, a BAV that is giving up, going caput, throwing in the towel. My cardiologist says 'sooner rather than later' for surgery. I've heard about the Da Vinci surgeries, but my cardiologist said he wasn't sure they did them on BAV, just the other heart valves. I'm really not looking forward to having my sternum split and have the zipper scar and long down time. That scares the hell outa me. I'm hoping someone can tell me they have had a BAV replacement done with minimally invasive surgery. I'm in the L.A. area of anyone knows a good referral.

 

[gerrys]

Eight weeks ago, I underwent AVR atage 59. There are a number of doctors that perform minimally invasive techniques, mine wasn't one of them. Although my surgery occurred rather quickly following diagnosis, I did have time to consider that alternative and discussed it with my surgeon. From our discussion and my research I found:
-While many DaVinci procedures occur each year, the procedure is still relatively new and data is still being collected on the overall success,
-Operating techniques vary among doctors relative to blood flow diversion during surgery and air removal from the heart as the heart is re-started,
-The operation requires more time on the operating table, more time under anesthesia,
-MIT limits the amount of other repairs that may be required if, in fact, other issues are discovered during the procedure.
That being said, reduction of the discomfort associated with the sternum dissection is sure appealing.
I have to say, though, that the traditional operation is really not that bad. With either technique, you still have to deal with the tubes, breathing exercises and the healing of the heart. Insofar as hospitl stay is concerned, I was in on a Thursday morning and home on Monday morning. The first two weeks after the operation are a chore, then the healing is pretty steady. At this point, I'm pretty much back to my normal routine, save heavy lifting and playing golf.
Good luck with your operation - all will go well. I hope some folks that had a DaVinci AVR chime in here. I too would like to hear their experience.

 

[marie]

We do have a hospital and a doctor that use the robot. I did not however. When they first started using it here they only used it for mitral valve and I had aortic. I think they now use it for aortic but I'm not really that familiar with it.

I did have minimally invasive where they cut over the right breast and go through the ribs. My scar is about two inches long. I had very minimally pain in the chest for for a few days however I still have some discomfort when I sneeze or cough.

My pain was in my right shoulder for a few days and then went to my left shoulder and stayed there for several weeks. My cardio tells me that their experience has been more shoulder pain with minimally invasive. I was not on the heart lung machine longer than the open chest.

It certainly wasn't a walk in the park but it was managable. Remember we are all different but this was my experience.
Good luck Earline

 

[Susan BAV]

I really don't know anything about minimally invasive OHS but wanted to welcome you.

Regarding surgeons, I think my wonderful surgeon may be retired--or nearly so. I've heard that the Governator chose Dr. Vaughn Starnes in LA, whom I met and liked also. There are others in LA that other members here really liked also.

 

[ctyguy]

I had a Mini-AVR at the Cleveland Clinic. However it was till a sternum cut but instead of an 8 inch incision it ended up being 4 inches. From what I've been told the healing time was about the same. Im 3 1/2 months now and pretty much back to doing everything I did pre surgery.

 

[ALCapshaw2]

I received the results of my angiogram today, pretty much what I expected, a BAV that is giving up, going caput, throwing in the towel. My cardiologist says 'sooner rather than later' for surgery. I've heard about the Da Vinci surgeries, but my cardiologist said he wasn't sure they did them on BAV, just the other heart valves. I'm really not looking forward to having my sternum split and have the zipper scar and long down time. That scares the hell outa me. I'm hoping someone can tell me they have had a BAV replacement done with minimally invasive surgery. I'm in the L.A. area of anyone knows a good referral.

Three Cheers for your Cardiologist !

With the high success rates for AVR, Sooner really is Better for several reasons.

I can't help but wonder what specifically "scares the hell" out of you about having your sternum split versus one of the Minimally Invasive Procedures.

I have had 2 sternotomies and only MINIMAL DISCOMFORT in my chest. ONE of the benefits of a sternotomy is that there is only SKIN over the sternum and NO large muscles are cut.

As a BAV patient, you have a better than 50% chance of also having a connective tissue disorder that may result in dilation of the Aorta. IF you also end up needing surgery to repair or replace part of your aorta, almost certainly the surgeon will need better access than can be realized with a Minimally Invasive technique.

SEVERAL recipients of Minimally Invasive OHS (and there are several types, depending on the point of entry) have reported Greater PAIN from that surgery than most of the recipients of full sternotomies. Note that there a Lots of Nerves along your Ribs, Bones are put under tension, and large muscles are often Cut using 'minimally invasive' techniques.

MANY OHS patients report more Back / Shoulder / Arm PAIN than sternum pain due to the way their bodies were pulled and stretched during surgery. MOST have found that Massage works Better and Faster for relieving Muscle Pain.

Bottom Line: "Minimally Invasive Surgery" sounds appealing at first mention BUT may have more drawbacks than an ordinary sternotomy.

Ask the surgeon(s) you interview about the approaches they offer and the tradeoffs in discomfort, healing time, operating time, and access to the needed area(s) before making your final decision.

'AL Capshaw'

 

[Leah]

Minimally invasive refers to a number of different things and, for aortic valve replacement, frequently/mostly seems to refer to a smaller sternum cut. Both the surgeon I spoke with at Cleveland Clinic and the surgeon I spoke with at Stanford apparently do a partial sternum split with a smaller cut than the traditional AVR but still the sternum and not robotically-assisted.

 

[SHEEPDOG]

I Have The Same Conserns!

I Have The Same Conserns!

I TOO AM IN THE WAIT MODE. I HAVE AVR SCHEDULED IN JULY @ ST JOSEPHS IN ATLANTA. THIS PLACE SAYS IT IS THE TRAINING HOSPITAL FOR THE ROBOTIC ASSIST SURG. IT ALSO SAYS IT IT IS NOT USED FOR AVR. MY DOC DOES A "MORE MINIMALLY INVASIVE" PROCEDURE. WHY DONT YOU JUST CALL A SURG SUGGESTED BY THE HOSPITAL AND ASK. ASKING NEVER HURT!
GOOD LUCK AND DONT WAIT TOO LONG IN THE INFERED "THAN LATER" TIME FRAME.
SHEEPDOG

 

[cday]

My husband had a partial sterno - 4 inch scar. His doctor does even a less invasive method (through the ribs) if he can, but it depends on exactly where your heart is and how it is tilted. Here your time in the hospital is the same without complications whether you have the full sterno, partial, or through the ribs -- 4 days.

 

[ryen0]

i think the reason the davinci method is better for mitral valve repair is that the valve is a little below the other one. with the port access camera they can actually see that valve better than if they had you cut all the way open.

 

[Magic8Ball]

I have no doubt most of us could change an oil filter on a car.

But if you asked me to cut a hole in the wheel arch of the car and change the oil filter through that it would be difficult if not impossilbe.

Thats my basic assessment of the option and why i never even considered it.

I told my surgeon he was allowed to cut me from ear hole to a*$e hole if it made his life easier and the outcome better.

18 months later, the chest hair covers most of it and the colour has faded.

The pain wasn't that bad at all (bar sneezing and coughing) so i'd do the same again if i had the choice.

 

[tomflies1]

BAV and m.i.s. or wide open surgery

BAV and m.i.s. or wide open surgery

Thanks for all the fine responses from everyone, it really helps to get all the different viewpoints. It sounds like I'm worried about cutting the sternum a bit too much, maybe it's not as bad as I imagine it to be.
Someone mentioned Dr Starnes at USC and I have actually been trying to get them to call me back, with no luck. I've left 4 messages so far. But I also have an appt with Dr. Trento at Cedars Sinai, Beverly Hills, this Thurs. Anyone have experience with him?
I'd also like to hear from some BAV people and what their symptoms are/were. I actually had no idea I had a heart problem until I took an EKG for an insurance policy. My personal doc confirmed the anomaly and sent me off to the cardiologist the next day. Then, a rude awakening. Thinking back a year or so, I started getting tired when I came home from work and began taking naps, also had some pain in my feet and ankles, and I did notice my heart seemed to pound a bit more when I walked up the stairs and hopped into bed. I just figured I was getting older and these things 'happened'.
Thanks again for your input.
Tom
55 yrs