The “minimal incision” approach

Your doctor will evaluate whether you are a candidate for a minimal incision procedure instead of traditional open chest surgery.

Minimal incision valve surgery does not require a large incision or cutting through the entire breastbone. The surgeon gains access to the heart through one to three smaller, less visible incisions (sometimes called “ports”) that can be made between the ribs or a smaller breastbone incision, as well as one small incision in the groin.

The diseased valve can be repaired or replaced through one or more of the ports between the ribs, with the surgeon looking at the heart directly through the incision or through a small tube-shaped camera.

Why you should ask your doctor about the minimal incision approach.

Which treatment option is right for you?

Choosing the right treatment option is extremely important and depends on many factors. It’s a decision that you should make in close cooperation with your doctor. Some of the factors you will need to consider when choosing a treatment option include:

• The benefits and risks of each type of treatment
• Your age
• Your specific medical condition
• Other medications you may be taking
• Your lifestyle needs and goals

Surgical Valve Repair

When possible, it is often preferable to surgically repair the patient’s valve rather than to replace it with a prosthetic device. Valve repair usually involves the surgeon modifying the tissue or underlying structures of the mitral or tricuspid valve and implanting an annuloplasty ring or band. Aortic valves are rarely repaired.

Surgical Valve Replacement

If the diseased native heart valve cannot be repaired, the surgeon may choose to replace it. The first step is to remove the diseased valve and then implant a prosthetic valve in its place. Prosthetic valves used to replace the heart’s natural valves come in different sizes to fit the patient and are made from a variety of materials.

There are two main types of prosthetic heart valves:

• Tissue (bioprosthetic) valves – made primarily from animal tissue [i.e., bovine pericardium (the sac surrounding a cow’s heart), a pig’s aortic (porcine) valve or human valves from cadavers]
• Mechanical valves – created from synthetic (man-made) materials

There is more than one surgical approach to valve repair and replacement, including “minimal incision,” which involves a smaller incision than the traditional “open chest” approach.

• “Open chest” surgery
• “Minimal incision” surgery