Mrs. Ana Fernandes and T Ashokan who had undergone Minimal Invasive Surgeries at the Press Conference
Bangalore, March 26, 2009: Wockhardt Hospitals Bangalore set yet another benchmark in cardiovascular surgery with one of its consultants Dr. Ganeshakrishnan Iyer, Consultant Cardio Vascular Surgeon,Wockhardt Hospitals performing a Mitral Valve Replacement surgery through Minimally Invasive Endoscopic Technique called the Minimal Thoracotomy Approach. The most important benefits being reduced surgical trauma and a shortened hospital stay.
Two patients were operated through this method with small incision in the right side of the chest measuring 3-4 inches 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.
T. Ashokan, 46 year old gentleman from Vellore was suffering from exertional dyspnea (breathlessness on exertion) for the last 4-5 years. He is a known case of Rheumatic Heart Disease (RHD) and his echocardiography showed severe mitral stenosis. After diagnosis he was advised for a Mitral Valve Replacement. Mr. Ashokan was admitted at Wockhardt Hospitals and underwent Minimally Invasive Endoscopic Mitral Valve Replacement. His post operative recovery was uneventful and recuperation has been very speedy.
Mrs. Ana Fernandes a 52 year old lady from Goa was suffering from breathlessness on exertion. She is a known case of rheumatic heart disease and her echo report revealed severe mitral stenosis and mild mitral regurgitation and was advised for a Mitral valve replacement surgery. She was admitted at Wockhardt Hospitals and underwent Minimally Invasive Endoscopic Mitral Valve Replacement. Her post operative recovery has also been uneventful and speedy recovery is seen.
According to Dr. Ganeshakrishnan Iyer, Consultant Cardio Vascular Surgeon at Wockhardt Hospitals, Bangalore “The conventional heart surgery needs an incision of about 6 - 8 inches made down the sternum, through bone and muscle. With this advanced right mini-thoracotomy method the surgery is performed with a 3-4 inch skin incision created in a skin fold on the right chest. 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.”
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 (degenerative) or as a result of 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.
You may call it a breakthrough but it is not happening for the first time. This breakthrough has already been achieved previously. One of my relative was operated by Dr. Pragnesh Joshi, cardiac surgeon at wockhardt surat for a similar valve replacement surgery in year 2008. to my knowledge he is the pioneer in starting this operation in india and has already carried out several such successful operations. But i would like to congratulate Dr. Iyer to have followed Dr. joshi is such a great opeation.
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