Keyhole Surgery

This question is probably a long-shot, but, you never know.

Has anyone come across keyhole surgery closing leakage on valves.

My latest Echo in May, showed accelerated deterioration on replacement Aortic and Mitral valves, and on a 'Shunt' from previous surgeries (see profile).

It's a vicious circle, the leakage has caused Hypertension, and I've now been diagnosed with Heart Failure with function at 38% and dropping.

My Cardiologist and the Heart Failure Clinic are hopeful that they can control the problem with medication going forward, but, time will tell if it's a success or not.

Surgeons have now reaffirmed that conventional surgery is not an option, which I've known for a while, but, I was hoping it would be a few more years before I hit Crunch Time. Anyway, it what it is.

My Cardiologist has now told me, that the Cardio Surgeons, are investigating the possibility of keyhole surgery with Paediatric Cardion Surgeons. Apparently it's rare on adults due to the risks involved.

As I say, a long-shot.

[10gingercats]

Yes. there is quite a risk involved with keyhole surgery due to something going wrong and then there has to be an emergency open heart job done with little or no prep. I have just been in discussion about this with surgeons and cardios(I am in the uk) and it has been decided not to go ahead and to keep my heart in as good nick as possible and thus avoid my leaking tricuspid valve from worsening . So They are giving me meds. to prevent accumulation of fluid around my heart and from my lungs.This means my heart will pump better. Also I take Bisoprolol to stop palpitations or at least severe ones. i am also slim and walk well so i need to keep in good general health.Some cardios play down the seriousness of keyhole surgery but take it from me it is a real threat. I was told the risk of death during surgery or just afterwards was in the range of 10%.

[Hidden in reply to 10gingercats]

Thanks for that.

I trust my Cardio, but, I was a bit dubious when he mentioned it last week.

I've a copy of one letter from surgeon to surgeon, which makes me think they're hawking the latest Echo and CT scan around.

It looks as though I'm in similar position, with Fluid around heart and lungs, I've been put on Bisoprolol as well, along with Entresto.

Cheers

[10gingercats in reply to Hidden]

I take 12and a half mgs of Spironolactone and 20mgs of Frurosimide once a day to keep the fluid at bay...and it works well... and 2.5 mgs of Bisoprolol twice a day for palpitations...which also works I also take Apixaban and one or two other non . related meds. I had very swollen legs for approx a year and a half and a half. GP was not taking this seriously so after stamping and storming a bit I got a hosp. referal where they made the link to the heart and prescribed acordingly. Fluid disappeared rapidly once I was on the Spironolactone AND Furosimide. The latter did not work alone and this is often what is prescribed in a large dose. For some reason the Spiron. and Furos. work together to get rid of fluid but far less well work alone.Good luck.I do hope you can get it sorted.

[BernieMB]

Which hospital do you attend?

[Paperlover]

I had keyhole surgery to repair my mitral valve prolapse and severe regurgitation last October. I know there are only certain conditions they can use it for and I had to have an angiogram beforehand to ensure I had no issues with my arteries but I don’t think I was at any greater risk than in an open heart operation. I was operated on at Northern General in Sheffield which is a specialist centre and they are very experienced. Ask your cardiologist to contact one of the specialist centres - I think there are about 5 - for an opinion on your individual circumstances. My cardiologist urged a watch and wait but my surgeon agreed I should have the operation sooner rather than later. I was only in hospital for 3 days and if it were not for an allergic reaction to the sutures, recovery time would have been as little as 4 weeks.

[Jocastina]

I would find out exactly what they mean by keyhole. As far as I understand (but I’m not a doctor!), there are a couple of types at least and they are very different.

Some valves can be repaired or replaced by trans catheter surgery, which is not open heart surgery and where they insert the valve or valve repair device up an artery, either via your wrist or your groin. Recovery is quicker but I don’t know what the particular risks for this are.

Then there is ‘minimally invasive’ valve repair/replacement, which I had for my mitral valve replacement.

This is where they make an incision in the right ribs (thoracotomy) but this is still open heart surgery in that they are operating directly on the heart (usually with a robotic device) and the patient has to be on a heart and lung machine (I had this via an incision in my groin) and drains will be put in (I had 2 small incisions in my right side chest for this) - as with more conventional open heart surgery via sternotomy (cutting the chest and sternum open at the front).

However, it is still major surgery - the main difference is that the incision is in a different place. Some people call it keyhole to distinguish it from conventional surgery via sternotomy, which I think is misleading. I also happen to think that minimally invasive is a somewhat misleading term but that’s what the surgeons call it (or a mini, for short)! Recovery time is not necessarily quicker - the time in hospital is the same. Recovery after that can be quicker but it depends on each individual case.

I’m not a doctor though so my understanding may need correcting but ask your doctors detailed questions to be clear exactly what they are proposing before you make any decisions.

Ask exactly what the surgery will entail, how long it will take, what anaesthesia you will have, what incisions you will have, how long you will be in hospital, how long for recovery, what pain to expect, how long before you can resume normal life, what help you will need, etc.

I hope this helps. I prefer to know as much as possible in advance. Best wishes, whatever they do.

[10gingercats]

It also occured to me that if your quality of life is good then you certainly should think very carefully about whether surgery is worth the risk. My q. o. life is fine. I am 83 and pretty active. I can walk well and for about an hour or longer if I want to and I am not at all breathless.No diabetes or other nasty diseases.

[BernieMB]

I had minimally invasive aortic valve replacement, also referred to as keyhole surgery as opposed to conventional surgery which is open heart surgery. The surgery was done at the Harefield which is a leading specialist centre in UK. I can’t praise the hospital enough. In your situation, if not already attending a specialist centre, I would get myself referred to one and explore all the options before making a decision. Did they explain why they were talking about paediatric cardiac surgeons?

[Dolphin14]

Check out TAVR and a transfemoral mitral valve

I would imagine they would want to operate under a controlled environment versus you getting sicker.

Getting prepared as to what the plan is if/when needed is probably a good idea for the team.

I'm not a Dr. just sharing a little information I have learned

I'm in the US not the UK. Not sure how things differ.

Best of luck to you.

🐬

[Hidden]

Thank you for all the responses, the time taken and information provided is much appreciated.