Monday, January 30, 2023

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Why Choose Geisinger For Heart Valve Surgery

How Long Will My Annuloplasty Ring Last After Mitral Valve Repair Surgery?
  • Valve repair expertise: We lead the way in repairing mitral valves. At Geisinger, the great majority of people with mitral regurgitation who require surgery have their valve repaired rather than replaced. Repair is often safer and better.
  • Team approach: Our heart care team works as one, carefully reviewing which cases need surgery and what other alternatives may be available. You not only benefit from your doctors expertise, but also the expertise and experience of everyone on the team. The team includes several top leaders in the field.
  • Continuity of care: Surgery can feel overwhelming for you and your family. Our heart care team is with you every step of the way, from heart valve disease diagnosis through surgery and recovery. Our goal is to return you to doing the things you love.

Why Might I Need Heart Valve Repair Or Replacement Surgery

Valve repair or replacement surgery is done to correct the problems causedby one or more diseased heart valves.

If your heart valve becomes damaged or diseased, you may have thefollowing symptoms:

  • The repaired or replaced valve doesn’t work correctly

There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your healthcare provider before theprocedure.

Minimally Invasive Mitral Valve Surgery

Minimally invasive mitral surgery is often more complex than minimally invasive aortic valve surgery for several reasons. First, due to its anatomic position, even the traditional surgical exposure of the mitral valve is much more challenging than for the aortic valve. In addition, while most patients undergoing aortic valve surgery undergo replacement, patients with mitral pathology often undergo mitral repair, which can be complicated. As such, depending on the particular mitral pathology, surgeons must be prepared to perform several techniques through small incisions. The mitral valve may be approached through a lower hemisternotomy however, in our experience, exposure can be challenging with this approach.

The development of an intra-thoracic cross-clamp allows for direct aortic clamping through a small stab incision. Many other specialized long, low profile instruments have also been required to allow for facile exposure and manipulation of the mitral valve through the chest. In addition, as this requires peripheral cannulation, all patients undergo preoperative CT scans through the femoral vessels to allow for the development of an adequate cannulation strategy prior to the OR.

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What Happens Before Heart Valve Surgery

You may have a chest X-ray, echocardiogram and electrocardiogram the day before your surgery. Other tests may include a CT scan, heart cath and lab tests.

  • A healthcare provider will shave and clean the area where your surgeon will be working.
  • Dont eat or drink anything after midnight the day of your surgery.
  • Check with your healthcare provider about which medications you can take before surgery.

Bring loose, comfortable clothes and shoes that are easy to put on. If you wear a bra, you may want to bring one thats easy to put on without raising your arms. The person who brought you to the hospital can hold on to these items for you during surgery.

Prosthetic Heart Valve Market To Surge Usd 197 Billion With Growing Cagr Of 111% By 2031

Heart valve replacement surgery cost in India  Vitamins Click

November 10th, 2022Allied Market ResearchReleases

Allied Market Research recently published a report, titled, Prosthetic Heart Valve Market According to the report, the global Prosthetic Heart Valve industry was valued at $6.9 billion in 2021, and is estimated to reach $19.7 billion by 2031, growing at a CAGR of 11.1% from 2022 to 2031.

Download Sample PDF at:

Prosthetic Heart Valve Market Overview:

An artificial heart valve, also known as a prosthetic heart valve, is inserted in the heart of someone who has cardiac vascular disease . A strong material such as carbon or titanium is used to construct the prosthetic valve. Mechanical heart valves, transcatheter heart valves, and tissue or bio-prosthetic heart valves are the three forms of prosthetic heart valves. Individuals have the option of picking a prosthesis based on their health state and the advice of their surgeon. The heart valve replacement method allows the diseased valve to be removed and replaced with an artificial valve.

Prosthetic Heart Valve Market Segmentation:

For Purchase Inquiry-

Prosthetic Heart Valve Market: By Region Outlook

North America

Europe

Asia Pacific

Middle East & Africa

Important Questions Being Answered by the Prosthetic Heart Valve Market Report:

What is the Prosthetic Heart Valve market size and growth?

What are the prominent and latest trends impacting the market?

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Interventional Heart Valve Procedures

Valley structural heart specialists also specialize in heart valve procedures such as transcatheter aortic valve replacement and MitraClip.

These procedures use a catheter that contains the replacement heart valve. Your provider will thread the catheter through an artery in the groin or shoulder area to replace the heart valve.

Heart Valve Repair And Replacement

Heart valve surgery is typically the best solution for most people with valve conditions that cant be managed with medication. A multidisciplinary approach involving cardiac imaging specialists and expert cardiovascular surgeons will aim to repair your heart valve, rather than replace it. Repairing a valve enables patients to avoid long-term use of blood thinners and the possibility of infection, as well as other potential risks.

The two types of replacement valves are:

  • Mechanical valves made of a durable material that can last 20 years or more, but they do require life-long blood-thinning drugs to prevent clots
  • Biological valves made from either human or animal tissue. They may not last as long as mechanical valves in individuals younger than 60, but they dont require the use of blood thinners

If you require heart valve surgery to treat your condition, your care team will help you understand which type of replacement valve is right for you.

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How Serious Is A

Developing A-fib after heart surgery leads to longer hospital recovery, more time in intensive care, and worse long-term outcomes, according to UpToDate. Along with the usual increase risk of stroke and heart failure, A-fib after surgery can increase your risk of infection, kidney dysfunction, and brain dysfunction.

A-fib typically develops within 7 days after open heart surgery. But it can also take up to 90 days to notice A-fib symptoms.

In some cases, A-fib is temporary, only lasting a few days. Then it goes away on its own.

For others, A-fib after heart surgery is permanent. It doesnt go away. In this case, youll need to receive treatment for the condition.

A Guide to Atrial Fibrillation After Open Heart Surgery. Jan. 8, 2021. U.S. News & World Report. Link.

Atrial Fibrillation After Surgical Correction of Mitral Regurgitation in Sinus Rhythm. 2014. Circulation. American Heart Association. Link.

Options for Heart Valve Replacement. American Heart Association. Link.

Non-Surgical Procedures for AFib. American Heart Association. Link.

Atrial Fibrillation Medications. American Heart Association. Link.

What Are The Symptoms of Atrial Fibrilation ? American Heart Association. Link.

How to Define Valvular Atrial Fibrillation? Oct. 2015. Archives of Cardiovascular Diseases. Link.

Atrial fibrillation. Centers for Disease Control and Prevention. Link.

Valvular heart disease. Link.

Mitral Valve Repair: Is Open Chest Or Robotic Surgery Better

What’s The Latest Research On Less Invasive Aortic Valve Surgery?

Medical Expert: Arnar Geirsson, MD, Chief of Cardiac Surgery, Yale New Haven Hospital

I just received a very interesting question about the surgical approaches to mitral valve repair. Jane asked me, Hi Adam Is open chest or robotic surgery better for mitral valve repair?

To provide Jane an expert opinion, I connected with Dr. Arnar Geirsson, Chief of Cardiac Surgery at Yale New Haven Hospital. Dr. Geirsson is a mitral valve repair specialist and Yale New Haven Hospital is a recipient of the Mitral Valve Repair Reference Center Award for the past three years.

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Coronary Artery Bypass Graft Surgery

Washington University heart surgeons use evidence-supported practices to reduce major complications such as wound infections, arrhythmias, hemorrhage and stroke during or shortly after a CABG operation. They also take other proven steps to optimize CABG outcomes in the areas of medication usage, physical rehabilitation and discharge planning.

Heartvalvesurgerycom: Advances In Mitral Valve Surgery

Patient education website HeartValveSurgery.com recently featured a webinar withJoanna Chikwe, MD, founding chair of theDepartment of Cardiac Surgery at Cedars-Sinai, about surgery to correct mitral valve regurgitation.

The mitral valve regulates blood flow from the hearts left atrium into the left ventricle. When a mitral valve leaks, blood can flow in the opposite direction, causing breathlessness, chest discomfort, palpitations and fatigue.

“You have a much bigger range of options now to treat any kind of valve disease than we did even three or four years ago,” Chikwe told HeartValvesurgery.com.

Leaking mitral valves can be replaced with mechanical or animal valves, though Chikwe said both of these options have drawbacks.

“If you have an animal valve, youre probably buying yourself another operation down the line,” she said during the webinar. “And if you have a mechanical or metal valve, theres less likelihood that youll need another operation, but you will have to take a blood thinner .”

Chikwe prefers to repair mitral valves whenever possible. “It’s one of the few things we do that, if you do it right, gets you back to a normal life expectancy,” she said.

About 95% of patients who had robotic mitral valve repair at Cedars-Sinai were alive and well five years later, according to research Chikwe shared.

Clickhereto view the webinar at HeartValveSurgery.com.

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Aortic Valve Reconstruction Surgery: Patient Advantages

Medical Expert: Chris Malaisrie, MD, Cardiac Surgeon, Northwestern Medicine

The trend toward aortic valve reconstruction is gaining momentum.

In the past, aortic valve replacement with a mechanical or tissue valve was typically the only treatment available to patients. Today, patients have multiple options for the treatment of aortic valve stenosis and aortic valve regurgitation via reconstructive techniques that often enable patients to retain their own native tissue.

To better understand the patient benefits of aortic valve reconstruction, we interviewed Dr. Chris Malaisrie, Professor of Cardiac Surgery at Northwestern University and the Co-Director of the Bicuspid Aortic Valve Clinic and the Thoracic Aortic Surgery Program at Northwestern Medicine in Chicago, Illinois. In our community, Dr. Malaisrie has successfully treated many patients including Jean Frank, John Pascarella and Tom Tansor.

Many Thanks To Leila Dr Chikwe Mama Rosa And Cedars

Heart Surgery Types

Many thanks to Leila and Dr. Chikwe for sharing their experiences and clinical research specific to the recovery from heart surgery. A special thanks goes out to the Cedars-Sinai team that takes such great care of heart valve patients!!! Yes, Mama Rosa that means you and the entire nursing team that helped Leila recover so quickly after her mitral valve repair!

Keep on tickin Leila!Adam

P.S. For the deaf and hard of hearing members of our community, I have provided a written transcript of Leilas video below.

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How To Prepare For Heart Valve Surgery

Before your surgical date, make sure to arrange for assistance or support for when you return home and are still in recovery. Talk to your family about what you might need and have a plan in place. You’ll also want to discuss any post-surgery questions with your doctor beforehand, such as foods to avoid and what medications you’ll be taking.

Your doctor may recommend that you pack a bag with a few items for the duration of your hospital stay, such as:

  • Eyeglasses, dentures, or hearing aids.
  • Comfortable clothing.
  • Items for entertainment, like a book, tablet, or music player.
  • Personal items, such as a toothbrush or shaving kit.

What You Should Know About Heart Valve Surgery:

  • The most common types of heart valve surgery repair or replace the aortic valve or the mitral valve.
  • Surgery is the best option for some types of heart valve problems and for certain people. But there are also less invasive options to repair or replace mitral and aortic valves. Talk to your doctor about which approach is right for you.

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Minimally Invasive Aortic Valve Surgery

The classic technique for aortic valve replacement involves a median sternotomy, with cannulation of the right atrium and distal ascending aorta for cardiopulmonary bypass. Aortic valve replacement is performed by placing multiple interrupted sutures in the aortic valve annulus after the diseased valve is excised. Sutures are then placed through a prosthetic valve and then each suture is tied to secure the valve in position. Isolated AVR has become a relatively safe procedure with an estimated mortality of less than 3%. However, while a full sternotomy provides excellent exposure to the heart, patients seeking less post-operative pain and quicker recovery have driven surgeons to develop less-invasive approaches.

Seeking to avoid a full sternotomy, Cosgrove and Sabik began performing AVRs through a right paramedian incision in the mid 1990s. This technique was not widely adopted for multiple reasons including significant challenges in wound healing, challenges in exposure when unexpected bleeding was encountered, and added the potential for vascular complications secondary to femoral arterial cannulation.

Incisions for minimally invasive aortic valve replacement. J-hemisternotomy , L-hemisternotomy , inverted-T partial sternotomy , right anterior thoracotomy .

What Are The Advantages Of Heart Valve Surgery

Understanding Leaking Heart Valves with Dr. Kevin Accola

Heart valve surgery can ease your symptoms, improve your life expectancy and help prevent death.

The potential advantages of heart valve repair vs. valve replacement are:

  • Lower risk of infection.
  • Less need for lifelong anticoagulant medication.

Valve surgeries, including valve repair and valve replacement, are the most common minimally invasive procedure.

The benefits of minimally invasive surgery include:

  • Lower risk of infection.
  • Other medical conditions you have.
  • How many procedures you have in a single operation.

Your cardiologist and surgeon will talk to you about these risks before your surgery.

If youve had a valve fixed or replaced, you may be at a higher risk of getting infective endocarditis. But this can also happen with a faulty valve that isnt repaired. In certain cases, your healthcare provider may prescribe antibiotics to keep you from getting endocarditis from some types of dental work. You can reduce the risk of endocarditis yourself by taking good care of your teeth.

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What Are The Risks Associated With Valve Disease Treatment

As with all surgeries, there are risks. Because every patient is different, your doctor and your health care team will discuss your treatment options and recommend the best option for you.

People who have damaged, repaired or replaced heart valves are at increased risk for developing an infection of the valve .

Is it true that dental work can increase risks for people with heart valve problems?

It depends. The American Heart Association does not recommend antibiotics before dental procedures, except for patients at the highest risk of endocarditis. If a person has had heart valve surgery, but has not had a heart valve replaced, the cardiologist or surgeon will decide if antibiotics are needed. Read more about the antibiotic prophylaxis guidelines for infective endocarditis.

Key Learnings From Leilas Recovery Expecations After Heart Surgery

Here are insights from this conversation with Leila and Dr. Chikwe:

  • Leila Saeid is a mother, wife and dentist in Southern California. Leila was diagnosed with a heart murmur due to mitral regurgitation in 2000. Leila was asymptomatic and monitored the leaking valve with regular echocardiograms for the next 20 years. Leading up to her surgery, Leila was very anxious. I was a terrible patient, Leila shared.
  • According to Dr. Chikwe, approximately 50% of patients are asymptomatic. Unfortunately, asymptomatic patients may not get treatment at a time that could be beneficial to their health . Cardiologists were traditional taught that you wait until symptoms until you send somebody to fix the valve, states Dr. Chikwe. We now know thats not the best way to handle this for the vast majority of people with severe mitral valve regurgitation and a floppy mitral valve.
  • After Leilas heart valve disease progressed from moderate to severe mitral regurgitation, Dr. Chikwe performed a robotic mitral valve repair surgery to provide Leila a durable outcome that often returns patients to a normal life expectancy.
  • For Leila, Dr. Chikwe leveraged a minimally-invasive robotic approach that did not break her sternum or ribs. The incision was the size of a credit card.

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Procedural Steps Of Axillary Artery Cannulation

The procedural steps of axillary artery cannulation are outlined in Supplementary Video 1. Following a 3 cm infraclavicular incision, the axillary artery is identified. After placement of cannlation sutures, direct puncture of the axillary artery is performed using Seldingers technique. Echocardiographic visualization of the wire is crucial to avoid vascular injury. After placing the dilatator over the wire, a 58 mm incision of the axillary artery is performed. Afterward, the arterial cannula is carefully placed 1.52 cm into the vessel avoiding any resistance. Depending of the size of the axillary artery, we use a 18 Fr. or 20 Fr. short-tip Medtronic cannula. After fixation of the cannula, another stay suture is placed at the skin level to prevent dislocation of the cannula during cardiopulmonary bypass perfusion.

Preparing For Heart Valve Surgery

Mitral Valve Repair Heart Surgery High

Heart valve repair and replacement can significantly improve quality of life. At Montefiore’s Comprehensive Heart Valve Repair Program, heart valve surgery is a two- to five-hour procedure that is performed using the most advanced, minimally invasive techniques. While heart valve surgery is fairly straightforward, it is important that patients adhere to the Heart Valve Repair Program’s pre- and postsurgical guidelines to ensure the best results. Patients should also understand the risks associated with heart valve surgery as well as the procedure itself.

To adequately prepare for heart valve surgery, the Heart Valve Repair Program suggests that patients:

  • Become familiar with what happens during minimally invasive heart valve surgery.
  • Understand the difference between heart valve repair and heart valve replacement.
  • Learn what to expect prior to, during and after valve surgery
  • Review the Heart Valve Repair Program’s discharge instructions in order to make appropriate arrangements in advance.
  • Read about what life is like after heart valve surgery.
  • Listen to the Heart Valve Repair Program’s podcast about heart valve repair and heart valve replacement.
  • Review the Heart Valve Repair Program’s list of commonly asked questions about valve surgery.

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