When patients have a very damaged or narrowed mitral valve, surgery may be the best path forward to ensure that they live a long and healthy life. At Georgia Heart Institute, we offer the latest techniques to give patients safe, effective options to treat mitral valve disease no matter how complex their condition is. While open mitral valve repair surgery is an option at Georgia Heart Institute, most of our mitral valve repairs are performed through minimally invasive techniques, either robotic surgery or a catheter-based mitral valve clip (such as Mitraclip®.)
Patients should consider mitral valve repair when:
- They are experiencing symptoms from mitral valve disease such as shortness of breath, fatigue, palpations, or leg swelling.
- They have reduced heart function and blood flow to the body.
- Their heart has become enlarged.
- They have other heart conditions, like atrial fibrillation or hypertrophic cardiomyopathy, in addition to mitral valve disease.
Additionally, patients with no symptoms can benefit from robotic mitral valve surgery to head off potential negative impacts down the road.
Endoscopic Robotic Mitral Valve Repair
Georgia Heart Institute is one of the only programs in the United States to offer truly endoscopic robotic mitral valve repair. Our specialized team can access the damaged valve through tiny incisions below the armpit, rather than opening the chest cavity through a sternotomy (large incision through the breastbone) to access the heart. This reduces post-surgery pain and recovery time significantly, while offering the same success rates as traditional surgery.
Frequently Asked Questions
Your surgical team will make five tiny incisions (8mm, about the diameter of a pen) for the robotic instruments, robotic camera, and access to the heart. Then the cardiothoracic surgeon will operate the robot from a computer screen in the operating room. From there, the surgeon will use the robot to surgically repair your mitral valve.
One of the most important things in any heart surgery is for your surgeon to have a good view of the part of the heart they are operating on. Because of the position of the mitral valve, robotic surgery is a great option because the mitral valve is easy to view with this approach.
Success rates do vary depending on the type of mitral valve disease a patient has, but typically mitral valve repair has a high success rate. For mitral valve prolapse, success rates are between 95 – 100% for high volume centers. Robotic mitral valve repair has comparable or better success rates to open mitral valve surgery.
Yes, and robotic surgery can be ideal for patients who have previously had open heart surgery. When a sternotomy is performed, it tends to leave scar tissue that can make additional heart surgeries or re-operations difficult. But the robotic approach gives the surgeon a different way to access the heart or even re-perform a mitral valve repair that has failed.
Yes, the heart does need to be stopped, but the approach to temporarily stopping the heart is also minimally-invasive, just like the surgery.
In open heart surgery, when the heart is bypassed, tubes are placed into the heart to put the patient on a heart-lung bypass machine. Our program is one of the few in the world that using “percutaneous” techniques to place the catheters. In other words, instead of making an open incision to access the blood vessels, needles and tiny incisions are used to place the catheters. With robotic mitral valve repair, we will thread a catheter into a blood vessel in the leg and guide it up to the heart. We will then give the heart a specific medicine (cardioplegia), which stops its function until we’re ready to restore blood flow again after your mitral valve surgery is complete.
Unless the mitral valve is simply too damaged, we will recommend repairing your existing valve over replacing it. Mitral valve repair has a high success rate, and, unlike mitral valve replacement, it doesn’t require patients to continue to take blood thinners long-term, which can increase the risks of bleeding and stroke. While mitral valve replacement can be performed using our robotic technique, the incisions are usually larger (30 mm) to be able to fit the replacement valve into the chest.
We are able to treat other conditions at the same time when we perform robotic mitral valve repair. For example, we can perform the following procedures simultaneously:
- Septal myectomy for hypertrophic cardiomyopathy
- MAZE procedure for atrial fibrillation (Afib)
- Left atrial appendage closure for atrial fibrillation
- Heart tumor surgery
- Atrial septal defect closure
- Tricuspid valve repair or replacement
While many patients, even those of advanced age, are great candidates for surgical robotic mitral valve repair, for some patients surgery simply may not be an option. In those cases, our team will evaluate if a patient would be a good candidate for a non-surgical, catheter-based procedure called Mitraclip. Learn more about Mitraclip.
Why choose Georgia Heart Institute?
Georgia Heart Institute is focused on providing leading cardiovascular care across of the state of Georgia through focusing on quality of care, research and offering the latest and most effective treatment options. As one of the only institutions in the state offering robotic mitral valve repair, we’re setting the standard for cardiovascular surgery and ensuring that our patients can lead long, heart-healthy lives.
Connect with our program
Referrals are required for surgical services, but our knowledgeable team is always happy to answer your questions and provide next steps. Call 770-219-7099 to discuss your surgery with our team.
If you are a clinician who needs to refer a patient for cardiothoracic surgery, please contact our program directly at 770-219-7099. Our program coordinator can answer any questions you have and help schedule your patient to see one of our board-certified cardiothoracic surgeons.