Specialist Procedures

Mr Paul Modi MD FRCS is a British, US and German-trained consultant cardiac surgeon with expertise in minimally invasive (keyhole) heart surgery.

Minimally Invasive Aortic Valve Replacement

The aortic valve is a one-way valve comprised of three leaflets that conducts blood flow from the main pumping chamber of your heart, the left ventricle, into the largest artery in your body, the aorta, which conducts blood throughout the rest of your body. When the left ventricle squeezes blood into the aorta, the aortic valve normally closes to prevent blood from flowing back into the left ventricle.

Diseases of the aortic valve are functionally classified into those that cause the valve to leak, known as aortic regurgitation or insufficiency, and those that narrow its opening, known as aortic stenosis. For both conditions, surgical replacement of the valve with a prosthetic valve may be needed.

The most common surgical approach to the aortic valve requires the surgeon to saw open the breastbone and spread the edges apart to gain direct access to the heart. Although this approach provides excellent exposure of the whole of the heart and great vessels, it is very invasive and takes several months to recover from with substantial activity restrictions. With a minimally invasive aortic valve replacement (AVR), a 2-3 inch skin incision is made and only part of the sternum is divided (approximately one-third to one-half) thus better preserving the integrity of the thoracic skeleton. Via this small skin incision, exposure of the aortic valve is superb and an experienced surgeon can implant a new valve. The greatest benefits of a minimally invasive AVR are faster speed of recovery and superior cosmetic result with some evidence that blood loss and need for blood transfusion are reduced.