Minimally Invasive Mitral Valve Repair Surgery

Minimally Invasive Mitral Valve Repair
Written with A. Marc Gillinov, M.D. and Tomislav Mihaljevic, M.D.

What is minimally invasive mitral valve repair surgery?

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With more than 3000 minimally invasive procedures completed, Cleveland Clinic has the nation’s largest experience with minimally invasive mitral valve repair surgery. Employing state-of-the-art techniques, today minimally invasive valve surgeries account for 87 percent of the minimally invasive cardiac surgeries performed at Cleveland Clinic.

Minimally invasive mitral valve repair surgery is performed through a small incision, often using specialized surgical instruments. The incision is 2 to 4 inches instead of the 6- to 8-inch incision required for traditional surgery. Robotically assisted keyhole approaches or port-access techniques are also available for some types of surgery.

Cleveland Clinic offers full range of minimally invasive mitral valve surgery approaches

Cleveland Clinic heart surgeons have expertise with the full range of minimally invasive approaches for mitral valve repair, enabling us to offer individualized treatment for each patient. These minimally invasive valve procedures, which range from a 2 to 4 inch incision to fully endoscopic surgery, include:

Mitral valve repair via a right mini-thoracotomy
Mitral valve repair via a partial upper sternotomy
Robotically-assisted, endoscopic valve repair

Benefits of minimally invasive mitral valve surgery

The benefits of minimally invasive mitral valve surgery may include:

Reduced pain
Reduced blood loss
Reduced risk of infection
Shorter hospital stay
Faster recovery
Faster return to work
Less scarring, improved appearance after surgery

traditional incision Traditional heart surgery incision

The incision is larger (about 6 - 8 inches), made down the sternum, through bone and muscle

Right Mini-Thoracotomy

mini thoracotamy The right mini-thoracotomy is performed with a 2 to 3 inch skin incision created in a skin fold on the right chest, providing an excellent cosmetic result.

The heart is approached between the ribs, providing the surgeon access to the mitral valve. There is no sternal incision or spreading of the ribs required for this surgical technique.The surgeon inserts special surgical instruments through the incision to perform the valve repair. Results with this approach are excellent

Partial Upper Sternotomy

partial sternotomy
A partial upper sternotomy includes a 2- to 3-inch skin incision and division of the upper portion of the sternum, providing the surgeon access to the mitral valve to perform the repair. In contrast, a traditional sternotomy requires an 8 to 10 -inch incision down the entire sternum.

The partial upper sternotomy offers the surgeon an excellent view of the mitral valve and may be an appropriate approach for patients who require combined mitral valve and aortic valve procedures.

Robotically-Assisted Mitral Valve Repair

robotic assisted heart surgeon Robotically-assisted mitral valve surgery is a type of minimally invasive surgery in which the surgeon uses a specially-designed computer console to control surgical instruments on thin robotic arms. The robotic arms are introduced through a 1- to 2-cm incision in the right side of the chest. The surgeon’s hands control the movement and placement of the endoscopic instruments to open the pericardium (thin sac that surrounds the heart) and to perform the procedure.

Robotically-assisted mitral valve surgery provides the surgeon with an undistorted, three-dimensional view of the mitral valve, leaflets and subvalvular structures with the use of special camera. This approach enables surgeons to perform complex repairs without the need for division of the breast bone (sternum) or spreading of the ribs, in most cases.

Robotically-Assisted Incision robot assisted incision

Learn more

If you would like to find out if you are a candidate for minimally invasive mitral valve surgery or learn more about minimally invasive heart surgery, click here to contact us or call the Heart and Vascular Institute Resource & Information Nurse at 216/445-9288 or toll-free at 866/289-6911. We would be happy to help you.