da Vinci Surgery
 

Mitral Valve Prolapse

The mitral valve controls blood flow through the left side of the heart. When it opens, the mitral valve allows blood to flow into the left ventricle -- the heart's main pumping chamber. When the left ventricle contracts, the mitral valve closes to prevent blood from flowing back toward the lungs.

Sometimes the mitral valve is abnormal from birth. It can also become damaged by infection, with age or from heart disease.

What is Mitral Valve Prolapse?

If the mitral valve leaflets cannot tightly seal the left ventricle, this is called prolapse. With mitral valve prolapse, some blood flows back into the atrium - a condition called regurgitation. Regurgitation can make the heart work harder, leading to further valve damage and increasing the risk of heart failure.

Mitral Valve Prolapse Treatment and Surgical Options

The treatment and surgical options for mitral valve prolapse depend on the severity of the condition, your symptoms and overall health. If you are not having symptoms or if your symptoms are mild, your doctor may suggest medication, lifestyle changes or no treatment at all.

Surgery

If your symptoms become severe, your doctor may recommend mitral valve surgery. The goal of surgery is to allow your valve to open and close properly. There are two common types of mitral valve surgery: valve repair and valve replacement.

With valve replacement, your surgeon cuts out the damaged valve and replaces it with a new, artificial valve. The new valve may be mechanical (from man-made materials) or biological (from human or animal tissue). With valve repair, your surgeon rebuilds one or more of the valve leaflets using your own tissue.

Your doctor will fully explain the pros and cons of replacing your valve versus repairing your valve.

During all types of mitral valve surgery, a heart-lung machine is used. This machine temporarily takes over the function of your heart and lungs during surgery. It provides surgeons with a still and blood-free surface during the procedure.

Whether repairing or replacing your valve, surgery may be performed using open surgery through a large chest incision or minimally invasive surgery through a few small incisions.

Open Surgery

During open surgery, doctors make a large chest incision and cut through your breastbone (sternum) to reach your heart. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your chest. Open surgery allows your surgeon to see and touch your heart and tissues. While open surgery allows your surgeon to see and touch your organs, it is invasive due to the large incision.

Minimally Invasive Surgery

Thoracoscopic Mitral Valve Surgery

During thoracoscopically-assisted surgery, doctors can repair or replace your defective valve through one or more small incisions instead of a large incision through the breastbone. Long, thin surgical instruments, including a tiny camera, are inserted through the incisions to reach your heart. The camera takes images inside your chest and sends them to a video monitor to guide surgeons as they operate.

da Vinci Mitral Valve Repair Surgery

Another minimally invasive surgical option for mitral valve repair is da Vinci Surgery. The da Vinci System may not be used for valve replacement procedures. You should talk to your doctor about whether this surgical approach is right for you. The da Vinci Surgical System uses the latest in surgical and robotics technologies. da Vinci is beneficial for complex surgery. With da Vinci Surgery you avoid the large chest incision used with open surgery

da Vinci is a state-of-the-art surgical system that features a magnified 3D high-definition vision system and special wristed instruments designed to take surgery beyond the limits of the human hand. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. Physicians have used the da Vinci System successfully worldwide in hundreds of thousands of procedures to date.

PN 1002212 Rev B 06/2013

The clinical evaluation of the da Vinci Surgical Systems (Models (S1200, IS2000, IS3000) supporting its use for mitral valve repair was not performed totally endoscopically. Introduction and manipulation of the endoscopic instruments were controlled by the da Vinci Surgical Systems through port incisions (< 1 cm) while accessory technologies, e.g., atrial retractor and cardioplegia line, etc, were introduced through a mini-thoracotomy. Performance characteristics for conduct of totally endoscopic mitral valve repair using the da Vinci Systems have not been established.

All surgery presents risk, including da Vinci® Surgery and other minimally invasive procedures.  Serious complications may occur in any surgery, up to and including death. Examples of serious or life-threatening complications which may require hospitalization include injury to tissues or organs, bleeding, infection or internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Risks of surgery also include potential for equipment failure and human error. Risks specific to minimally invasive surgery may include: A long operation and time under anesthesia, conversion to another technique or the need for additional or larger incisions.  If your surgeon needs to convert the procedure, it could mean a long operative time with additional time under anesthesia and increased complications. Temporary pain or discomfort may result from pneumoperitoneum, the presence of air or gas in the abdominal cavity used by surgeons in minimally invasive surgery. Research suggests that there could be an increased risk of incision-site hernia with single-incision surgery. Results, including cosmetic results, may vary.  Patients who bleed easily, who have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci® Surgery. For more complete information on surgical risks, safety, and indications for use, please refer to http://www.davincisurgery.com/safety/. Patients should talk to their doctors about their surgical experience and to decide if da Vinci Surgery is right for them. Other options may be available. Intuitive Surgical reviews clinical literature from the highest level of evidence available to provide benefit and risk information about use of the da Vinci Surgical System in specific representative procedures. We encourage patients and physicians to review all available information on surgical options and treatment in order to make an informed decision. Clinical studies are available through the National Library of Medicine at www.ncbi.nlm.nih.gov/pubmed.

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