Minimally Invasive & Robotic Mitral Valve Repair for Mitral Valve Disease

At NYU Langone’s Heart Valve Center, most people who require surgery for mitral valve disease have a procedure to repair, rather than replace, the damaged valve. Our surgeons specialize in three techniques for mitral valve repair: minimally invasive mitral valve repair, robotic mitral valve repair, and transcatheter mitral valve repair.

Our surgeons are internationally recognized for their expertise in minimally invasive mitral valve repair, including robotic mitral valve repair, and offer a range of surgical approaches, setting them apart from most other centers. Surgical teams at NYU Langone have developed advanced repair techniques that they have taught to hundreds of other surgeons from around the world. They specialize in complex repairs, with a success rate of about 95 percent. 

VIDEO: When Jay Potter was diagnosed with a severe heart murmur, he went to Dr. Didier Loulmet for a minimally invasive robotic heart surgery.

The goal is to repair rather than replace the mitral valve, though in rare situations our surgeons may perform a mitral valve replacement surgery. Mitral valve repair spares your own mitral valve and allows you to avoid replacing the valve with a prosthesis, which may require taking medication, such as a blood thinner, or replacing the artificial valve years later. 

With most mitral valve repair surgeries, our surgeons perform an annuloplasty, in which a synthetic band or ring is sewn around the mitral valve to restore it to its typical shape and size.

Minimally Invasive Mitral Valve Repair

Cardiothoracic surgeons at NYU Langone are often able to repair the mitral valve using minimally invasive techniques, rather than a traditional sternotomy, also called open chest surgery.

VIDEO: Minimally invasive mitral valve repair

Depending on the extent of damage to the mitral valve, surgeons recommend repair, instead of a valve replacement, for people with mitral valve regurgitation.

In a minimally invasive mitral valve repair, the surgeon makes a small incision on the right side of the chest, either above or below the breast, without breaking or cutting the breastbone, as in traditional sternotomy. He or she inserts surgical instruments to access the heart and repair the valve.

Mitral valve repair requires general anesthesia and a heart–lung bypass machine, which does the work of these organs during the procedure. You may spend four to seven days afterward in the hospital and then recover for a few weeks at home.

This procedure typically results in less blood loss, less postoperative pain, less scarring, and a shorter recovery time than sternotomy, or open heart surgery. Published research by NYU Langone doctors shows that the long-term clinical outcomes for 1,000 people who had minimally invasive procedures were equivalent to the outcomes of those who had a sternotomy.

Robotic Mitral Valve Repair

NYU Langone is one of the few medical centers in the country to offer robotic mitral valve repair, performed by highly trained experts at the Robotic Surgery Center.

VIDEO: Robotic mitral valve repair

These types of mitral valve repair typically result in less blood loss, less postoperative pain, less scarring and a shorter recovery time than sternotomy. They requires up to a four-day hospital stay, and recovery takes up to four weeks.

Our cardiothoracic surgeons who specialize in robotic cardiac surgery can use more complex, high-precision surgical techniques to repair damaged mitral valves in people with mitral valve regurgitation or stenosis.

Using robotic instruments, surgeons can make precise movements inside the heart in a range of motion the human hand isn’t capable of performing. During robotic surgery, a small camera provides surgeons with three-dimensional, magnified, high-definition views of the mitral valve.

Robotic procedures are performed through five pencil-sized incisions made between the ribs through the right chest wall, without having to displace tissue. These robotic procedures require general anesthesia and the use of a heart–lung machine to do the work of those organs during the surgery.

Similar to minimally invasive surgery, this procedure typically causes less blood loss, less postoperative pain, and less chance of infection, and it requires a shorter recovery time than traditional open-heart surgery. Most people require a three- to five-day stay in the hospital, as well as a few weeks of recovery at home. They can enjoy a better cosmetic result as well.

Transcatheter Mitral Valve Repair

NYU Langone surgeons also specialize in a minimally invasive technique known as a transcatheter procedure to repair the mitral valve.

Sternotomy

Rarely, for more complex mitral valve repair procedures, our surgeons may perform sternotomy. Though sternotomy typically involves dividing the breastbone to access the heart, NYU Langone surgeons can often perform the procedure by making small incisions between the ribs on the right side of the chest. 

During surgery, they reshape the mitral valve leaflets by removing excess tissue and suturing together the remaining segments. They may also close gaps in the leaflets or place sutures to help them function properly.

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