Our Summary

This research paper discusses a new surgical technique for adults with heart defects that need surgery on their pulmonary valve. In the past, repeated surgeries through the breastbone (sternotomies) were used, but these often led to complications and higher death rates. Instead, the researchers used a less invasive approach called a left anterior minithoracotomy, which they have been using for nearly 20 years for a different heart valve (mitral valve) surgery. This technique involves making a small incision in the chest to access the heart. Based on their initial results, this technique seems safe and reduces potential complications from repeated heart surgeries. The researchers used this technique on five patients, none of whom experienced complications or died after the surgery.

FAQs

  1. Why has the rate of surgical interventions on the pulmonary valve in adults been increasing?
  2. What is the left anterior minithoracotomy approach for addressing the pulmonary valve and right ventricular outflow tract in adult patients?
  3. What are the potential complications from multiple cardiac reapproaches?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pulmonary valve replacement is to follow postoperative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and gradually increasing physical activity as advised by their healthcare team. It is important to communicate any concerning symptoms or changes in health to their doctor promptly. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support the success of the valve replacement surgery.

Suitable For

Patients who are typically recommended for pulmonary valve replacement include:

  1. Adults with congenital heart defects who are experiencing extended lifespans and require reoperations on the pulmonary valve.
  2. Patients who have previously undergone multiple sternotomies and are at risk for elevated morbidity and mortality rates.
  3. Patients who have undergone minimally invasive video-assisted mitral valve surgery and may benefit from the left anterior minithoracotomy approach for addressing the pulmonary valve and right ventricular outflow tract.
  4. Patients who are at risk for complications from multiple cardiac reapproaches and may benefit from a minimally invasive approach to pulmonary valve replacement.

Timeline

  • Patient is diagnosed with a congenital heart defect involving the pulmonary valve
  • Patient undergoes various tests and evaluations to determine the best course of treatment
  • Patient is scheduled for pulmonary valve replacement surgery
  • Surgery is performed using a minimally invasive left anterior minithoracotomy approach
  • Patient undergoes postoperative monitoring in the hospital
  • Patient is discharged from the hospital and begins a recovery period at home
  • Patient attends follow-up appointments with their healthcare provider to monitor progress and address any concerns
  • Patient experiences improved heart function and overall quality of life following the surgery.

What to Ask Your Doctor

  1. What is the reason for needing a pulmonary valve replacement?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time and rehabilitation process?
  4. How long will the new pulmonary valve last and will I need additional surgeries in the future?
  5. Are there any alternative treatment options available?
  6. What is the success rate of this type of surgery?
  7. Will I need to take any medications or make lifestyle changes after the surgery?
  8. How often will I need follow-up appointments and monitoring after the surgery?
  9. What symptoms should I watch out for that may indicate a complication with the new pulmonary valve?
  10. Are there any restrictions on physical activity or travel after the surgery?

Reference

Authors: Toschi AP, Gomes RF, Pope RB, Bueno MB, Suchard C, Cidral I, Poffo R. Journal: Braz J Cardiovasc Surg. 2024 Oct 22;e20230324(e20230324):e20230324. doi: 10.21470/1678-9741-2023-0324. PMID: 39471256