Minimally invasive surgery, ultra-minimally invasive and nonsurgical

In revolutionizing the approach to the patient, among the most innovative techniques adopted in both cardiac surgery and interventional cardiology we find the minimally invasive and ultra-minimally invasive procedures, including percutaneous techniques, at the forefront. 

Besides having many advantages as regards the overall impact on the general condition of patients - increasingly older and more fragile due to the coexistence of other diseases that prevent the use of conventional treatment (open surgery)-, minimally invasive and ultra-minimally invasive techniques lower the risk of infections to a considerable extent; they reduce cardiorespiratory stress; they involve less intraoperative bleeding and they shorten healing and hospitalization times.

Terms like ministernotomy, minithoracotomy, transfemoral or transvenous access have therefore progressively established themselves in specialist activity with respect to modus operandi that required extensive incisions of the sternum and chest to reach the cardiac structures requiring intervention in order to correct functional defects or replace “parts” damaged by diseases. 

 

Repair operation

The morphology of the mitral valve is well suited to the repair procedure. In spite of this, it is necessary to turn to High Specialty Centers whose consolidated experience in terms of case reports, availability of state-of-the-art technologies and constant professional training of doctors allow operating safely and with the lowest possible risk of complications. 

Valvuloplasty has a lower operative mortality rate and a better long-term prognosis (improved survival) compared to the grafting of a mechanical or biological prosthesis. The degree of feasibility of the repair operation is quite high: over 90% of patients is considered eligible. Nevertheless, considering the individual valve disorders, not all subjects are good candidates for mitral plastic surgery.

Replacement operation

When the repair operation is not feasible, correction of the valve defect - stenosis - envisages the use of both biological and mechanical mitral prostheses.