Our Summary

This study looked at two different types of heart valve surgery: one that is done through a large incision in the chest (ST-MVS) and one that uses a smaller incision on the side of the chest (MT-MVS). The researchers wanted to see if one method had better outcomes than the other for patients who had already had heart surgery in the past. They found six past studies that included a total of 777 patients, and they combined the data from these studies to get a clearer picture.

What they found was that the smaller incision method (MT-MVS) had better results. Patients who had this type of surgery were less likely to die, less likely to need another operation because of bleeding, and they spent less time in the hospital. The chance of having a stroke was about the same for both methods.

However, the researchers caution that the studies they looked at weren’t the best quality, and that more and better research is needed. So, while the smaller incision surgery seems to be a safer option, it’s not totally clear-cut and more studies are needed to confirm these findings.

FAQs

  1. What were the two types of heart valve surgeries examined in this study?
  2. According to the study, which surgical method had better results?
  3. What were the limitations mentioned by the researchers in the study?

Doctor’s Tip

A doctor might tell a patient undergoing sternotomy to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include avoiding heavy lifting, keeping the incision site clean and dry, taking prescribed medications as directed, and attending follow-up appointments with healthcare providers. It is also important to listen to your body and report any unusual symptoms or concerns to your doctor promptly.

Suitable For

Patients who have previously undergone heart surgery and are in need of heart valve surgery are typically recommended sternotomy. This includes patients with a history of coronary artery bypass grafting, previous valve repair or replacement, or other cardiac surgeries. Patients with complex valve diseases or those who require multiple valve repairs or replacements may also be recommended sternotomy. Additionally, patients who have certain risk factors such as obesity, diabetes, or other comorbidities may be better suited for sternotomy due to the potential for better outcomes compared to other minimally invasive techniques.

Timeline

Before sternotomy:

  1. Patient is diagnosed with a heart valve condition that requires surgery.
  2. Patient undergoes pre-operative tests and evaluations to assess overall health and determine the best course of treatment.
  3. Surgery date is scheduled and patient is informed of the risks and benefits of the procedure.

After sternotomy:

  1. Patient is taken into the operating room and put under general anesthesia.
  2. Surgeon makes an incision in the chest, either through the breastbone (sternotomy) or through a smaller incision on the side of the chest (MT-MVS).
  3. Heart is stopped and blood is rerouted through a heart-lung machine.
  4. Surgeon repairs or replaces the damaged heart valve.
  5. Patient is taken to the intensive care unit for monitoring and recovery.
  6. Patient begins physical therapy and rehabilitation to regain strength and mobility.
  7. Patient is discharged from the hospital and continues to follow up with their healthcare team for aftercare and monitoring.

What to Ask Your Doctor

  1. What is a sternotomy and why is it necessary for my heart valve surgery?
  2. What are the potential risks and complications associated with sternotomy?
  3. Are there alternative surgical approaches to sternotomy that could be considered for my case?
  4. How does the recovery process differ between sternotomy and other surgical approaches?
  5. What is the success rate of sternotomy compared to other surgical approaches for heart valve surgery?
  6. Are there any specific factors in my medical history that make sternotomy a better or worse option for me?
  7. How experienced is the surgical team in performing sternotomy procedures?
  8. What can I expect in terms of pain management and rehabilitation after a sternotomy procedure?
  9. Are there any long-term effects or considerations to keep in mind after undergoing a sternotomy procedure?
  10. Are there any lifestyle changes or precautions I should take after undergoing sternotomy surgery?

Reference

Authors: Daemen JHT, Heuts S, Olsthoorn JR, Maessen JG, Sardari Nia P. Journal: Eur J Cardiothorac Surg. 2018 Nov 1;54(5):817-825. doi: 10.1093/ejcts/ezy173. PMID: 29688301