Does small scar indicate an op without bypass

[kentishbunny1]

I am little confused, my surgeon at Kings has said that my heart valve replacement surgery will be done by only needing a small incision, quite high up. Does that mean that I wont go on bypass or need a breast bone break? Am slowly digesting what I will be going through in the next few weeks and keep thinking of things. So much I dont yet know. Any thoughts appreciated.

[IanGordon]

Hi kb1. There's a wealth of experience on this forum, but no substitute for qualified medical advice and experience, so use any appointments as information gathering opportunities, if necessary, writing down your queries beforehand.

Whilst a full sternotomy is still the 'gold standard' for open heart surgery, there are increasingly minimally invasive options on offer, including robotic mitral valve surgery. Heart valve replacement surgery will require you to go on a bypass machine and the heart to be stopped whilst the malfunctioning valve is removed and a mechanical / bioprosthetic valve stitched in.

Working through a small incision is more challenging for the surgeon but offers a quicker recovery for patients as the surgery is less invasive although studies seem to suggest there are not great advantages over separating the sternum (breast bone). There's always the caveat that certain circumstances may dictate reverting to a full sternotomy during surgery.

My experience of my aortic valve replacement was the central separation of the the sternum which after surgery is wired together to enable the bone to heal and fuse. Scary to imagine but not so bad in reality.

Hope this helps.

[bantam12]

My husband is hoping to have valve replacement at the Brompton, it will be done through a tiny incision around the side of the rib cage and he won't need to go onto a bypass machine, as yet he hasn't got the go ahead.

[Prada47]

Is this the procedure ? bhf.org.uk/informationsuppo...

[IanGordon in reply to Prada47]

Good call Prada47.

TAVI is of course the least invasive of valve replacement surgeries and generally reserved for those patients where other methods represent too high a risk. It's also the higher cost option I believe because of the complex collapsible valve which is inserted via the femoral artery without a requirement for the heart to be stopped, hence no time on bypass.

[MichaelJH Heart Star]

A small incision means minimally invasive surgery. This applies for some valve work and occasionally bypass surgery when one or two easily accessible arteries are involved (few are that lucky). However, if there is any issue the operation will become full open heart surgery.

[Glasgowgirl1947]

I had 2 valves repaired by keyhole surgery. I have cuts in my breast and one on each side of my groin, I had only 2 stitches. Don't worry about ICU it certainly was nothing like the TV. Perhaps they will let you have a look around the ward before you go on to it. Your breast bone won't be opened and you won't have what people call the zipper down your chest. I don't think I was put on the heart lung machine, to be honest I didn't ask!! The main problem I've had is nerve pain in my legs. My consultant has said it could take weeks or months to get better. Good luck with the operation hope it goes well.

[Ymail65 in reply to Glasgowgirl1947]

Hi I had the same op

Last july

Only went in one side of groin

My thigh is still numb

Did you get those horrible electric shoxks

[Glasgowgirl1947 in reply to Ymail65]

I certainly did, I couldn't lift my foot off the ground first time I had to walk, the shocks going down to my knee were horrific. It still feels raw/ super sensitive 6 weeks on, I also got pain in my left leg a couple of days after I was mobile. I was left disabled after a bad knee replacement op and I know what nerve pain is I've suffered since 2017. I'm praying this doesn't become permanent. The physio was so concerned she spoke to the surgeon and phoned me twice after I got home. He said it could take weeks or months to sort!! Your problem doesn't fill me with hope, I had a mastectomy in 1989 and still have highly sensitive patches under my armpit and 1 numb and 2 sensitive patched down the back of my arm. I guess you get used to this? It just really shocks me if some kind person tries to help me down, say from a bus, it always seems to be the left armpit they grab and then I have to grin and say thanks EEEEEK!!!!

[Glasgowgirl1947 in reply to Glasgowgirl1947]

I forgot to say I didn't have stitches on the groin wound, the stitches were in my breast. I think the groin wounds were glued.

[MichaelJH Heart Star in reply to Glasgowgirl1947]

I had issues with my right hand post "full works" bypass. Took about three months to settle although I still get the occasional tingling in the little finger but small price to pay as I was pretty carp before my op

[MichaelJH Heart Star]

Just a note to readers here. Minimally invasive surgery is great for people who have an option. But it should be remembered if there is any issue it becomes open heart for access. This happened to someone at rehab and he was quite shocked by the turn of events. His wife, though, said the surgeon has explained this possibility in detail but he did not want to listen. Forewarned is forearmed!

[Glasgowgirl1947]

I had my repair done keyhole I have a couple of cuts in my breast and one on each side of my groin. The idea is that the recovery time should be much quicker. My groin was glued I think and I had 2 stitches in my breast. I have had a lot of problems including AF so am on Warfarin which has caused one of the groin wounds to open and it has been bleeding but I do think that most people recover very well and you don't have a huge cut on your chest, a few people called it their zip fastener! I've just been unlucky.