Minimally Invasive or Open Surgery? | MedStar Health

Minimally Invasive or Open Surgery?

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2017 Fall

Vinod H. Thourani, MD, the new chairman of Cardiac Surgery for MHVI and an expert in surgical and transcatheter mitral valve procedures, says, “In addition to deciding between repair or replacement of the mitral valve, MHVI surgeons can help patients decide whether their operation should be a conventional full sternotomy or via the minimally invasive techniques.” That same governing principle—what’s best for each individual patient—applies to the choice between open or minimally invasive procedures.

The traditional open surgical approach involves a sternotomy. Minimally invasive procedures use a partial sternotomy or non-sternotomy incision through the right side of the chest.

Vinod H. Thourani, MD, is the new chairman of Cardiac Surgery for MHVI.

Dr. Thourani notes that MHVI is poised to be in a unique position for the entire Mid-Atlantic region. “With our valve program heart team assessment and surgical expertise,” he says, “patients are evaluated for traditional mitral valve surgery or the minimally invasive and transcatheter approaches. Patient outcomes and quality are paramount during this process of shared decision-making for the treatment of mitral valve disease.”

Chronic Severe Mitral Regurgitation

Indications for Treatment of Mitral Regurgitation

  • Any symptoms (NYHA II-IV) Class I
  • LV dysfunction Class I
    • EF<60% or serial decrease in EF -LVSD>40mm or serial increase ESD
  • Pulmonary hypertension Class IIa
  • RV dysfunction Class IIa
  • Atrial fibrillation Class Ila
  • Asymptomatic severe MR with preserved LV function
    • The likelihood of successful repair without residual MR>90% Class IIa
    • Low risk for OR
    • Referred to surgical centers experienced in MV repair Class I