PUNE: A team of doctors at Sahyadri Hospitals, led by Cardio Thoracic Surgeon Dr Mahendra Bafna from Pune, performed a valve replacement on a 27-year-old man through a small incision. The man was aware of the problem in the heart valve from last 7 years. After he was diagnosed having a leaked aortic valve, doctors suggested replacement of the valve but he was afraid of the large incision that had to be made in middle of the chest to approach the heart and the pain after cutting the sternum bone. Hence, he avoided surgery and tried medical treatment from multiple hospitals.
Then, he visited Sahyadri super speciality hospital, Karve Road, Pune. He expressed his fear of the large incision and bone pain. Dr Mahendra Bafna, Cardio-Thoracic Surgeon, Sahyadri Hospitals, counselled him and planned his aortic valve replacement (AVR) through a small incision in the right upper part of his chest. Surgical procedure took 7 hours, while it takes about 2 to 3 hours for normal sternotomy method. The patient was in ICU for the monitoring of his vitals and shifted to his ward in 24 hours. He was stable and discharged in four days.
Speaking about the case, Dr Mahendra Bafna commented that several studies have shown that patients undergoing minimally invasive aortic valve replacement have a shorter hospital stay, less pain, shorter duration of ventilation, less blood loss and less blood transfusion than patients undergoing conventional full sternotomy.
“Post-operatively, the patients can be mobilised earlier and respiratory function may also be better. Limited exposure of the operative field is a disadvantage for the surgeon and this is reflected in longer operative time in minimal invasive cases compared with operations conducted through a full sternotomy,” said Bafna.
He further added that minimally invasive AVR is technically even more difficult in patients with small and calcified aortic roots.
“This could be one of the reasons that minimally invasive aortic valve replacements is not yet being universally performed. This procedure needs no special costly instruments and is easily reproducible,” added Bafna.
