Performing more than 400 minimally invasive heart valve repair surgeries

I have spoken to many cardiac valve patients that have said they are afraid of having an open surgical sternotomy. They say it is a powerful reason to put off surgery when they are told about the many months of a painful recovery, respiratory compromise and the possibility of an infected large wound.

But for select patients, there's an alternative: minimally invasive valve surgery through a 5-centimeter incision instead of a 25-centimeter incision needed to divide the sternum.

Since 2007, our cardiovascular surgery team at Mayo Clinic Health System in Eau Claire has had one of the few high-volume practices (over 400 cases) in the U.S. We have helped many patients, specializing in the minimally invasive approach for aortic valve replacements, mitral valve repair or replacement and tricuspid procedures.

I sought training in the minimally invasive procedure over a decade ago in response to so many of my patients' apprehension over sternotomy. I was hearing them say, "I just don't want my sternum cracked or split open." It seemed to me that if you could keep the sternum intact and still do the procedure, then the patient was better off. The typical minimal approach recovery is several weeks, as opposed to several months, long.

The main differences of the minimally invasive approach are:

• Specialized surgical tools with longer handles, pincer grip and modified motions for manipulation, stitching and tying knots
• Smaller access, afforded by 5-centimeter surgical opening.
• New visualization methods in which only the surgeon sees the operative field; the team watches multiple wall screens broadcasting video recorded through the surgeon's camera

Our team continues to learn more about new approaches and look at patients who can benefit from a less-invasive procedure. Although not all patients qualify for this procedure, if you have been told that you have a heart condition and will need surgery, speak to your provider about the option of having a minimally invasive procedure done.

You can also hear more in this video on minimally invasive aortic valve replacement.

Robert Wiechmann, M.D., is a cardiothoracic surgeon in Eau Claire, Wisconsin.