Minimally Invasive Heart Valve Surgery
The goal of heart valve surgery is to repair the defective valve or replace it with a prosthetic valve, improving heart function and extending life expectancy. In minimally invasive heart valve surgery, the cardiac surgeon performs the procedure through small incisions in the right side of your chest, in contrast to open-heart surgery. At the Department of Cardiac Surgery at Sheba Medical Center, our highly experienced medical team is the first to perform minimally invasive valve surgery in Israel, and we are a world leader in complex valve repairs.
What conditions can be treated with minimally invasive valve surgery?
The human heart has four chambers and four valves. The right and left atria are the two chambers at the top of the heart, and the two bottom chambers are called ventricles. Essentially, the heart functions as a muscular pump in which the atria receive blood from the different parts of the body, and the ventricles pump blood back to all the tissues of the body. The valves are responsible for maintaining the unidirectional blood flow between the different sections of the heart.
Changes in the structure of the heart tissue can disrupt blood flow and lead to valvular heart disease. Diseases of the valves are categorized into two types:
- Valve failure: when it does not close to the end and allows a backflow of the blood; this is also known as a “leaky valve”
- Stenosis: when it does not open to the end and obstructs the healthy flow of blood
Life-threatening heart failure can develop as a result of these valve diseases. Fortunately, the early detection of a valve disorder enables treatment, such as minimally invasive valve surgery that can prevent heart failure and death.
How is the procedure performed at Sheba?
In all types of minimally invasive valve surgeries, cardiac surgeons access the heart through small incisions made between the ribs on the right side of your chest. A small endoscope and specialized surgical instruments are inserted into these incisions, and the surgeon is guided by a magnified, high definition video image projected on a nearby monitor. At Sheba, we use a state-of-the-art 3D camera, which gives the surgeon a sharper view of the valve – leading to a shorter operating time and a more effective repair.
The entire procedure, which takes about two to three hours, is done through a minuscule opening (Heartport Access), thereby eliminating the need for a full thoracic opening. As a result, the surgery is associated with less pain and trauma to the body. The risk of complications is greatly reduced, and the size of the scar is minimized.
During the valve surgery, the patient must be connected to a heart-lung bypass machine, which keeps blood flowing through the body during the procedure. In minimally invasive valve surgery, the tubes of the heart-lung machine are inserted through a blood vessel in the groin, with the aid of a 2-inch incision.
After the procedure, you must spend a day or more in the intensive care unit (ICU), receiving fluids, medication, and nutrition through an intravenous line. The total amount of time that you need to stay in the hospital is three to four days on average, depending on your individual condition.
Your Sheba team will monitor your condition and watch for any signs of infection in the incision sites. We will help to manage any postoperative pain that you may experience. After you are discharged from the hospital, you will need regular follow-up exams and testing. Your doctor may also recommend cardiac rehabilitation to help you strengthen your heart. In most cases, the outcome of minimally invasive valve surgery is excellent, and patients report significant improvements in their overall health.
Who is a candidate?
Not every patient is a candidate for minimally invasive valve surgery. Sheba’s doctors will meet with you and review your case to determine whether this procedure is a suitable option to treat your condition. The decision is highly individual, depending largely on the judgment of our experienced cardiac surgeons.
What are the possible complications?
Complications are extremely rare and similar to those associated with all types of surgery, such as bleeding and infection of the surgical wounds. However, as a result of weakness, low blood pressure, and/or new medication, we caution all patients about an increased risk of falls.
In order to help prevent infections, lung ventilation is essential. You may therefore be instructed to practice breathing exercises and respiratory physical therapy under the guidance of our nursing staff. In addition, a dietitian will provide guidelines about what to eat (generally, soft foods) in the days immediately following the surgery, in order to prevent nausea and not overwhelm the stomach.
Why choose Sheba for minimally invasive valve surgery in Israel?
The Department of Cardiac Surgery at Sheba has already performed hundreds of mitral valve and aortic valve replacement procedures and more than 1,200 open heart surgeries per year. We treat approximately 3,500 inpatients and 2,500 outpatients annually. This makes us the most versatile heart surgery center in Israel, with extensive experience in adult heart surgery, pediatric heart surgery, heart transplantation, and many complex operations.
Our skilled team features surgeons who have trained at the world’s leading hospitals, and we constantly upgrade our operating rooms, laboratories, and imaging services – ensuring that you benefit from the most advanced technologies available. At present, we are the only cardiac department in Israel that implements the minimally invasive thoracoscopic assisted open-heart surgery and the Heartport Access system, which enables our surgeons to perform open heart procedures through a small (5-8 cm) incision below the right breast. This method is the first step towards true robotic surgery, and Sheba is proud to pioneer this cutting-edge technique.
In addition, to facilitate each patient’s treatment at Sheba, we assign a personal medical coordinator from our International Medical Tourism Division to provide assistance with every detail. Our staff is deeply committed to providing holistic, patient-centric healthcare that considers every aspect of your well-being.
Meet Our Team
Sheba Medical Center
Leonid Sternik, MD
Leonid Sternik, MD
Director, Department of Cardiac Surgery
Dr. Sternik has been the department director since 2018, and he specializes in the field of cardiothoracic surgery. Before immigrating to Israel, he received his medical degree from the Moscow School of Medicine. Dr. Sternik completed a clinical fellowship at the Mayo Clinic, USA, during which he performed hundreds of complicated heart surgeries. He has published dozens of articles in international medical journals, is responsible for many cardiac surgery research studies, and is an editor of the leading Journal of Thoracic and Cardiovascular Surgery.
Sheba Medical Center
Prof. Ehud Raanani, MD
Prof. Ehud Raanani, MD
Director, Leviev Cardiovascular and Thoracic Center
Prof. Raanani is a specialist in the field of cardiothoracic surgery. He received his medical degree from the Sackler School of Medicine at Tel Aviv University, and he completed a clinical fellowship in cardiac surgery at the University of Toronto. He has extensive experience in the surgical repair of heart valves, as well as in the surgical repair of aneurysms and the aorta. Prof. Raanani is actively involved in many research studies in the field of cardiac surgery and has published over 150 articles in international medical journals and chapters in textbooks.
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