Minimally Invasive Mitral Valve Surgery
What is Mitral Valve Disease?
The mitral valve consists of two leaflets, supported by chordae and papillary muscles, and located between the left atrium and left ventricle of the heart. The mitral valve prevents blood from leaking back into the lungs when the heart contracts. When the valve fails, patients may be severely affected.
Degenerative mitral valve disease is a common disorder affecting around 2% of the population. Common findings include a “prolapse” ( slipping or falling our of place), due to elongation or rupture of the chordal apparatus. When the two leaflets fail to close tightly, the mitral valve becomes insufficient, sometimes allowing blood to leak back into the atrium from the ventricle. A prolapse can occur on either the anterior (front) leaflet or the posterior (rear) leaflet. Usually, the annulus, where the leaflets attach, is also dilated or enlarged.
Patients with isolated mitral valve disease may be candidates for minimally invasive surgery, so long as they do not have clinically relevant aortic valve disease or coronary artery disease. Surgeons perform the operation by making only a small 4-6 cm incision on the right side of the chest instead of the large midline-incision and division of the sternum used traditional open surgery.
The surgery is performed through the small space between the ribs. The heart-lung machine is inserted via a small incision in the groin, allowing the heart to be stopped during repair of the valve. A soft retractor is inserted, which gently opens the narrow space between the ribs, enabling the surgeon to insert the specialized minimally invasive instruments. An endoscope, ideally with a 3D camera, is inserted that will provide a high-resolution image of the mitral valve.
Using this technique, the stability of the chest is fully preserved, patients recover more quickly, and the minimal scar will be barely visible after the patient recovers.
During the operation, the valve is thoroughly inspected and a strategy developed for performing the repair. Artificial chords made out of GoreTex, which function like natural chords, are inserted at the location of the ruptured chords,. The sutures are then passed through the papillary muscles and are extended to the free edge of the leaflet. The suture length is then adjusted to conform to the geometry of the valve. Later, an annuloplasty ring is sized and implanted to support the repair, and maintain the optimized valve geometry.
What Are the Benefits of Minimally Invasive Mitral Valve Surgery?
Reduced pain, blood loss and risk of infection
Shorter hospital stay
Faster recovery and return to work
Less scarring and improved appearance after surgery
The Estimated Cost includes –
1. Operation Theatre Charges
2. Surgeon’s Cost
3. Anaesthetist’s Cost
4. ICU & Room Rent
Estimated Cost Excludes
1.Clinical Lab Charges
2. Professional Charges
3. Nursing Charges
5. Dietary Charges for the patient and an attendant
6. Stay outside the hospital, cost of the same is not included in the above estimate and is payable on actual.
8. Any outpatient consultations and medicines which are required during the follow-up will not be a part of the estimate.
9. The estimate cost is for the number of days indicated above, if situation demands to extend stay in hospital, the additional days stay would be charged accordingly.
10. If any device or implants used will be charged at actual.
11. Special Investigations referred by other departments or if situation demands any additional investigation would be charged accordingly.
12. Cost for the evaluation is not included in the above mentioned estimation.
13. Cost of Impants