“Open chest” heart valve surgery

During conventional “open chest” surgery to repair or replace a heart valve, the surgeon makes one large main incision in the middle of the chest and breastbone to access the heart. A heart-lung machine takes over the job of circulating blood throughout the body during the procedure, because the heart must be still and quiet while the surgeon performs heart valve surgery.

Many surgeons are able to offer their patients minimal incision valve surgery as an effective alternative to open chest heart valve surgery. Your surgeon will evaluate the best surgical approach for you.

Why the minimal incision approach may be a better option.

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

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