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Cardiac Care & Robotic Surgery

When medication and catheter-based treatments cannot relieve symptoms, surgery remains the accepted treatment for a range of cardiothoracic conditions, including but not limited to mitral valve prolapse, atrial septal defect and coronary artery disease.

Facing either traditional cardiac surgery or open surgery to treat disorders of the organs and tissues in the chest cavity can be a frightening experience. While it may be difficult to focus on next steps, you may in fact have several choices to make, including which hospital and which surgeon to go to and which procedure to choose. Learning as much as possible about your surgical options, including minimally invasive alternatives to traditional open surgery, may ease some of your concerns.

While surgery is generally the most effective way to treat disorders of the heart, lungs and esophagus, traditional open surgery has a number of inherent drawbacks caused primarily by making a large incision, splitting the breastbone and spreading the ribs to access the thoracic space. In addition to an 8- to 10-inch scar down the center of your chest, splitting the breastbone leads to a lengthy recovery time of eight to 12 weeks, as well as a prolonged delay before returning to normal daily activities.

Fortunately, less invasive options are increasingly available for patients facing cardiothoracic surgery. Many cardiothoracic surgeons are recognizing the benefits of smaller incisions made between the ribs to perform coronary bypass or make repairs to the heart or esophagus under visualization using thoracoscopy — the insertion of a miniaturized video camera between the ribs. But this approach has limitations and is not well suited to more complex cardiac procedures.

Robotic-assisted technology now provides surgeons and patients with what may be the most effective, least invasive treatment alternative for even the most complex cardiothoracic procedures, such as mitral valve repair. Among the benefits of are a reduced risk of infection, less blood loss and need for blood transfusions, a shorter hospital stay, less pain and scarring, faster recovery and a quicker return to normal activities.

Mitral Valve Prolapse & Treatment

The mitral valve controls blood flow through the left side of the heart. When it opens, the mitral valve allows blood to flow into the left ventricle,— the heart's main pumping chamber. When the left ventricle contracts, the mitral valve closes in order to prevent blood from flowing back toward the lungs. Sometimes the mitral valve is abnormal from birth. It can also become damaged by infection, with age or from heart disease.

What is mitral valve prolapse?

If the mitral valve leaflets cannot tightly seal the left ventricle, this is called prolapse. With mitral valve prolapse, some blood flows back into the atrium, a condition called regurgitation. Regurgitation can make the heart work harder, leading to further valve damage and increasing the risk of heart failure.

Mitral valve prolapse treatment options

The treatment options available to somebody with mitral valve prolapse depend on the severity of the condition. Some patients may not require any intervention. Others may be prescribed medications. However, if your symptoms become severe, your doctor may recommend mitral valve prolapse surgery. There are two basic types of valve prolapse surgery: valve repair and valve replacement. In valve replacement, your surgeon cuts out the damaged valve and replaces it with a new, artificial valve. Valve repair involves the surgeon reconstructing your valve using your own tissues.

Robotic-Assisted Mitral Valve Repair

If your doctor recommends surgery to treat mitral valve prolapse, you may be a candidate for robotic-assisted mitral valve repair, potentially the most effective least invasive surgical option available.

This surgery is an alternative to conventional open heart surgery — the traditional way to treat mitral valve disease — enabling your surgeon to operate with unparalleled precision and control through a few small incisions.

Illustration showing the difference between open and robotic-assisted surgical incisions Open Surgical Incision                              Robotic-Assisted Incision

This surgical process can help your surgeon repair your valve and help you avoid mitral valve replacement, in which your natural valve tissues are cut away and replaced with an artificial valve. This is important because a repair can provide you with many significant advantages compared with mitral valve replacement, including no need to take life-long blood thinners, less need for reoperation, reduced risk of surgical complications, a higher long-term survival rate and improved heart function. A recent study suggests that robotic surgery may allow surgeons to complete 50% more repairs than they can when using an open surgical approach.

In addition to avoiding the pain and trauma of sternotomy and rib spreading, robotic-assisted surgery provides most patients with the following benefits over open surgery:

  • Less risk of infection
  • Less blood loss and need for blood transfusions
  • Shorter hospital stay
  • Significantly less pain and scarring
  • Faster recovery
  • Quicker return to normal activities
  • Potentially better clinical outcome

As with any surgery, these benefits cannot be guaranteed, as surgery is both patient- and procedure-specific. While the technology is considered safe and effective, it may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits. 

For a referral to a skilled robotic surgeon at Suburban Hospital, call 301-896-3939.