Our Summary

This research is about two types of surgery for high-risk heart patients: minimally invasive mitral valve surgery (MIMVS) and conventional sternotomy (ST), which involves opening up the chest. The researchers looked at 86 papers, and found seven that compared the two types of surgery in high-risk patients.

These seven studies involved 1,254 high-risk patients. The researchers looked at how many patients died in hospital, what happened during and after the surgery, and how long patients lived.

In three of the studies, fewer patients died in hospital after the minimally invasive surgery than the conventional surgery. The other four studies didn’t find a significant difference. The time patients spent on a heart-lung machine during surgery was the same in one study, but was longer in the minimally invasive surgery in three other studies.

In six of the studies, patients who had the minimally invasive surgery had fewer complications after surgery. Of the studies that looked at how long patients lived, one found that patients who had the minimally invasive surgery lived longer, while two others didn’t find a difference.

In conclusion, even though the minimally invasive surgery might take longer and require more time on a heart-lung machine, it’s just as safe as the conventional surgery in terms of how many patients die and how many have complications. For high-risk heart patients, the minimally invasive surgery might even be better.

FAQs

  1. What types of surgeries were compared in the research for high-risk heart patients?
  2. What were the main findings of the studies comparing minimally invasive mitral valve surgery and conventional sternotomy?
  3. Is minimally invasive mitral valve surgery safer than conventional sternotomy for high-risk heart patients?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sternotomy is that while it is a common and effective procedure for certain heart surgeries, there are also minimally invasive options available that may have lower risks of complications and shorter recovery times. It’s important to discuss all available options with your doctor to determine the best approach for your specific situation.

Suitable For

Patients who are considered high-risk for traditional sternotomy, such as those who are elderly, have multiple comorbidities, or have previously undergone chest surgeries, may be recommended for minimally invasive mitral valve surgery. This approach may offer a lower risk of complications and potentially better outcomes for these patients.

Timeline

Before sternotomy, a patient may undergo various tests and consultations to determine the best course of treatment for their heart condition. They may also receive pre-operative instructions and medications to prepare for the surgery.

During sternotomy, the patient will be put under general anesthesia and the surgeon will make an incision in the chest to access the heart. The sternum will be cut and separated to provide access to the heart for the necessary procedures.

After sternotomy, the patient will be monitored closely in the intensive care unit (ICU) for a period of time to ensure they are stable and recovering well. They will receive pain medication and antibiotics to prevent infection. Physical therapy and breathing exercises may also be recommended to aid in recovery.

Overall, the recovery process after sternotomy can be lengthy and may involve several weeks of rest and rehabilitation. Follow-up appointments with the surgeon and cardiologist will be necessary to monitor the patient’s progress and ensure they are healing properly.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sternotomy include:

  1. What are the risks and benefits of minimally invasive mitral valve surgery compared to conventional sternotomy for high-risk patients?
  2. How many high-risk patients have you treated using minimally invasive surgery versus conventional sternotomy?
  3. What is the success rate of minimally invasive mitral valve surgery in high-risk patients compared to conventional sternotomy?
  4. How long does the minimally invasive surgery typically take compared to conventional sternotomy?
  5. What is the recovery time and expected outcomes for high-risk patients undergoing minimally invasive surgery versus conventional sternotomy?
  6. Are there any specific criteria or factors that would make a high-risk patient a better candidate for minimally invasive surgery over conventional sternotomy?
  7. What are the potential complications and side effects associated with minimally invasive mitral valve surgery in high-risk patients?
  8. How does the long-term survival rate compare between minimally invasive surgery and conventional sternotomy for high-risk patients?
  9. Are there any alternative treatment options available for high-risk heart patients besides minimally invasive surgery and conventional sternotomy?
  10. What is your experience and expertise in performing minimally invasive mitral valve surgery on high-risk patients?

Reference

Authors: Moscarelli M, Casula R, Speziale G, Athanasiou T. Journal: Interact Cardiovasc Thorac Surg. 2016 Jan;22(1):92-6. doi: 10.1093/icvts/ivv275. Epub 2015 Oct 8. PMID: 26451001