MD, ΜSc, PhD, FETCS, FCCP
Director Minimal Invasive Cardiac Surgery Department in "Metropolitan General" Minimally invasive aortic valve replacement
Minimally invasive aortic valve replacement is a modern and highly specialized method performed by specific and experienced cardiac surgeons and tends to replace the classic open method with a large mid-sternotomy while it transcends transcutaneous implantation.
Cardiac surgeon Christoforos Kotoulas answers our questions about the method, which promises the patient a return to his daily habits without symptoms and without risk to his life.
When should the patient have surgery doctor?
A patient should be operated when he suffers from severe stenosis or severe aortic valve insufficiency. The diagnosis is made with a transthoracic echocardiogram or in addition with the esophageal echocardiogram when necessary. The patient may have symptoms or may not. In both cases there is a need to evaluate each patient individually for the other health problems they may have. Symptoms are usually chest pain, shortness of breath that can lead to pulmonary edema and momentary episodes of fainting.
Can medication delay surgery?
Medication should be taken by patients when they discover the presence of valve pathology. However, when the valve damage becomes severe, then the patient should be treated surgically.
What are the surgical methods?
Today, surgery can be performed either with the open surgical method, or intrathecally with the TAVI method. Forget this open classic treatment with a 20-30 cm incision in the middle of the sternum! Modern practice requires a surgical incision of about 5-7 cm in the middle or on the sides of the chest. The operation is performed under general anesthesia. The heart surgeon, after opening the aorta, removes the damaged valve of the patient and inserts the new valve. The surgery lasts 2 to 3 hours. The operation is called minimally invasive aortic valve replacement – MIAVR. The transatlantic TAVI method is performed on older patients or patients with special problems. The valve is inserted through a catheter, usually from the thigh. The valve is only biological and has a limited lifespan, while its Achilles heel despite the advancement of technology is needed to install a pacemaker in a large percentage of patients, paravalvular leakage and the occurrence of stroke. In case of complication the patient should be treated with the classic open surgery urgently.
What are the benefits of minimally invasive replacement?
- excellent aesthetic result
- there is minimal blood loss
- a very short stay in the ICU is required
- pain is minimized
- the mobilization is immediate
- there is a reduction in infections and postoperative complications
- hospital stay is required for 4-5 days
- full return in one month
- is addressed to all ages
- applies to all aortic valve diseases
- aortic aneurysm is also treated
- all kinds of valves are used
- minimal opening of the pericardium resulting in easy reoperation, if needed in the future.
This technique leads to a very fast recovery, a very quick return to normal life with an excellent aesthetic result.
Which method is appropriate?
At Metropolitan General, the minimally invasive heart surgery clinic specializes in all modern and classical techniques, minimally invasive surgery or TAVI. We do not adapt the patient to the treatment, but the treatment to the patient. With the aim of the patient’s health, and with the weapon of knowledge, after the complete analysis of the patient’s history, we lead to his individualized treatment, with excellent clinical, aesthetic and spectacular results.
Leof. Kifisias 38, Abelokipoi Athens
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Papanastasiou 3, Hrakleio Crete
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