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Monday, February 13, 2012 - VCU Pauley Heart Center sees great results with minimally invasive valve surgery

The VCU Pauley Heart Center at VCU Medical Center offers minimally invasive valve surgical services that often result in less surgical trauma, faster recovery times and smaller scars. Surgeons use the minimally invasive techniques for the repair and replacement of the aortic or mitral valves, as well as for a wide range of other heart surgeries, including the removal of tumors from the heart, repair of holes in the heart and treatment of abnormal heart rhythms.

“We approach every patient as a candidate and only exclude them if they have significant coronary artery disease that requires open-heart surgery,” said Dr. Derek R. Brinster, director of the Thoracic Aortic Surgery Program in the Division of Cardiothoracic Surgery and an associate professor of surgery at VCU.

Minimal-incision valve surgery does not require cutting through the entire breastbone. Instead, surgeons gain access to the heart through smaller, less visible incisions that can be made between the ribs or a smaller breastbone incision, as well as one small incision in the groin. The diseased valve then can be repaired or replaced with the surgeon looking at the heart directly through the incision or through a small tube-shaped camera.

The smaller incisions result in less blood loss and smaller scars. Additionally, because patients experience less trauma to the sternum, they are able to use their arms after surgery, allowing for improved postoperative rehabilitation. Overall, patients recover more quickly and may spend fewer days in the hospital following surgery.

“The most appealing benefit is the ability to treat elderly and more complex patients,” Dr. Brinster said. “Patients who were considered too high risk for surgery before are now being offered surgery with better results.”

Dr. Vigneshwar Kasirajan, chair of Division of Cardiothoracic Surgery, estimates that 50 percent of the medical center’s valve surgeries are now done with minimal-incision procedures.

“We’re not unique in that we are doing minimally invasive valve surgery,” Dr. Kasirajan explained. “We’re unique because of our very high success in repairing valves. Our ability to take complex valve disorders and repair them is a very important part of our practice.”

The benefits of repairing a patient’s existing valve, rather than replacing it entirely, are many: patients don’t need to take blood thinners; they can avoid many of the risks associated with valve replacement, including blood clots, valve failure and infection; and they have very low risk of needing another surgery within 10 to 15 years.

“A high percentage of our patients come from other hospitals that do cardiac surgery,” Dr. Brinster added. “Our routine day is made up of highly complex patients. We typically take on the most challenging cases and we get good results, thanks to teamwork between intensive-care physicians, anesthesiologists, cardiologists and nurses.”

The Minimally Invasive Valve Surgery Clinic is held at the VCU Medical Center every Wednesday and Friday from 8 a.m. to noon. To schedule an appointment, please call (804) 828-4663 or (804) 828-4620.

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