The Practice Pulse January 2017
Minimally invasive valve surgery
The Florida Heart and Lung Institute is pleased to partner with North Florida Regional Medical Center to now offer minimally invasive cardiac valve surgery.
While traditional open heart surgery involves a full sternal incision and complete division of the sternum, minimally invasive valve surgery uses smaller incisions causing less trauma to the patient and encompasses a spectrum of approaches. For example, the aortic valve can be addressed either through an upper partial J-type sternotomy where the sternum is only opened from the sternal notch down to the third or fourth interspace on the right hand side leaving two thirds of the sternum intact, or occasionally through a small right anterior mini-thoracotomy in the second and third intercostal spaces. Similarly, the mitral valve may be approached through either a lower partial sternotomy, or through a right anterior mini-thoracotomy through the interspace.
Minimally invasive valve surgery conventionally refers to the aortic or mitral valve most commonly, although it’s possible (it can be the preferred method) for any of the 4 cardiac valves.
The studies that have compared conventional valve surgery to minimally invasive valve surgery have demonstrated significant patient benefit in appropriately selected patients. These benefits include a reduced length of hospital stay, decreased pain, expedited recovery, more rapid return to full activity, a reduced need for transfusion during hospitalization, and improved cosmetic result.
While not every patient is an appropriate candidate for minimally invasive heart surgery, we begin each new patient evaluation with the mindset of this less invasive surgical option. During every evaluation for aortic stenosis, we also consider if the patient would be better served by transcatheter aortic valve replacement (TAVR). TAVR is a totally percutaneous method of treating aortic stenosis, and we will address that in full detail in a further issue of The Practice Pulse.
Charles T. Klodell, MD
The latest murmurs
“North Florida Regional Medical Center is very excited to be advancing our Heart and Vascular Program with the addition of Dr. Klodell and his clinical team. Our team of Cardiologists and Cardio Thoracic Surgeons have a tremendous history at North Florida Regional of providing outstanding clinical care, and with the addition of Dr. Klodell, we will be advancing into the more complex and minimally invasive Heart Surgery arena with new procedures around Valve and Aortic surgery. The cardiology and surgical team will be launching our TAVR program in the first quarter which will expand our investment into minimally invasive approaches to healthcare. 2017 will mark an exciting time in North Florida Regional’s rich history in Cardiovascular care.” - Brian Cook, CEO
“We are embarking upon some truly groundbreaking changes with the expansion of Cardiovascular Services. With the current and newly added team members, I have no doubt we will reach the goal of providing excellent care, and achieving great outcomes for the patients in our community and beyond!” - Brian McCain, Director of CVU/CCU
Florida Heart and Lung Institute