Valve Types and Eligibility
Medline explains that before heart valve replacement surgery can be done, the patient needs to talk with his doctor to choose what kind of replacement valve will be used. Some replacement valves are made out of mechanical tissue, such as ceramics, cloth or metal. These valves are long-lasting, but the patient will need to take blood-thinning drugs (such as aspirin or warfarin) for the rest of her life. Other heart valves are made out of tissue harvested from human or animal cadavers. These valves typically need to be replaced every 12 to 15 years, but patients often do not need to take blood thinning medications after the procedure. In addition, the surgeon has to evaluate the patient to see if she is eligible for minimally invasive heart valve replacement. Experts at the Texas Heart Institute explain that patients who need more than one valve replaced, have clogged arteries, or are obese are not good candidates for this kind of surgery.
Traditional Minimally Invasive Approach
Medline notes that there are multiple different surgical approaches that qualify as "minimally invasive" for heart valve replacement. The traditional minimally invasive approach uses multiple small incisions to gain access to the heart instead of one long incision. The Cleveland Clinic on minimally invasive valve surgery notes that with a minimally invasive approach, the incisions are approximately 3 to 4 inches long instead of 6 to 8 inches in length (as is seen with open heart surgery). Although the actual valve replacement is the same, using smaller incisions reduces the risk of infection and other complications and also allows the patient to recover more quickly.
Alternative Techniques
Some hospitals have the facilities to use special instruments for other minimally invasive valve replacement approaches. Valve replacement can be done with an endoscope, which is a small flexible camera. This involves three or four much smaller cuts and requires special tools for performing the surgery. Some surgeons perform robotically-assisted valve replacement surgery. Medline explains that for this type of procedure, two to four very small cuts (approximately half of an inch long) are made in the chest. The surgeon then guides robotic arms in order to very precisely perform the valve replacement.
