Aortic valve surgery has traditionally been performed by opening the patient's chest. Likewise, the standard approach for performing mitral valve repair or replacement requires major open-heart surgery. An alternative to these methods has been developed using minimally invasive surgical techniques. Early follow-up suggests this simplified approach reduces patient pain and morbidity without jeopardizing surgical results. The limited incision makes opening and closing of the chest easier and faster without compromising the surgical exposure or access.
These smaller incisions have several potential advantages. There is less trauma and less pain reported by patients. The smaller incision used in minimally invasive surgery eliminates the back pain often reported after traditional heart surgery. Also, a small wound reduces the potential for wound infection and blood loss. Patients are extubated earlier and discharged from the hospital earlier. Clearly, the smaller incision is cosmetically more acceptable to patients. A re-operation through the traditional approach also should be less difficult because the pericardium below the sternum remains intact, protecting the heart during reentry.
In selected patients, minimally invasive valvular surgery reduces complications, accelerates patient recovery, allows for earlier hospital discharge and lowers overall costs. Although experience is limited and follow-up is short, the feasibility of this approach has been established.