Wockhardt Hospitals Bangalore performed a Mitral Valve Replacement surgery through Minimally Invasive Endoscopic Technique called the Minimal Thoracotomy Approach. An important benefit of this approach is the reduced surgical trauma and a shortened hospital stay.

Dr Ganeshakrishnan Iyer, consultant cardio vascular surgeon performed the procedure on two patients. A small incision in the right side of the chest measuring three to four inches was done as against the conventional midline sternotomy where the incision is in the front of the chest and measures about 12-14 cms. The rarely used minimally thoracotomy incision can confer the advantages of a smaller surgical wound, reduced blood loss, decreased risk of infection, shorter ICU stay, early discharge, decreased postoperative pain and a smaller cosmetically more acceptable postoperative scar.

The two patients aged 46 and 52 years were suffering from exertional dyspnoea or breathlessness on exertion for the last four to five years. Both cases were suffering from Rheumatic Heart Disease (RHD) and their echocardiography showed severe mitral stenosis. The post operative recuperation for both patients have been quite speedy.

The minimally invasive endoscopic method of cardiac surgery has emerged as a new and significantly successful approach to a variety of cardiovascular surgical procedures. Minimally invasive valve surgery may prove even more promising than new coronary procedures because detailed vascular anastomoses are not required. The mitral valve was easily accessible in these two patients through right minithoracotomy, stated Dr Iyer.

Traditionally Mitral valve replacement is an open heart procedure performed by cardiothoracic surgeons to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the 'inflow valve' for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, and into the heart through the mitral valve. When it opens, the mitral valve allows blood to flow into the heart's main pumping chamber called the left ventricle. It then closes to keep blood from leaking back into the lungs when the ventricle contracts (squeezes) to push blood out to the body. It has two flaps, or leaflets. Occasionally, the mitral valve is abnormal from birth (congenital). More often the mitral valve becomes abnormal with age or rheumatic fever. In rare instances the mitral valve can be destroyed by infection or a bacterial endocarditis.

Mitral regurgitation may also occur as a result of ischemic heart disease (coronary artery disease). Often the mitral valve is so damaged that it must be replaced. Through this new and advanced minithoracotomy method the heart is approached between the ribs, providing the surgeon access to the mitral valve. There is no sternal incision or spreading of the ribs required for this surgical technique. The surgeon inserts special surgical instruments through the incision to perform the valve repair.