Surgeon Q&A: Is Minimally Invasive Mitral Valve Re-Replacement Possible?
Written By: Allison DeMajistre, BSN, RN, CCRN
Medical Expert: Junaid Khan, MD, Cardiac Surgeon, Alta Bates Summit Medical Center
Reviewed By: Adam Pick, Patient Advocate
Published: March 28, 2024
Innovations in heart valve replacements are constantly on the move. Ten years ago, if you needed a new mitral valve, the only available options were either through the sternum or with a minimally invasive procedure through a small incision in the chest. Today, transcatheter mitral valve replacement (TMVR) has become a viable option for select patients.
Given these options, many patients are wondering which type of procedure is right for them. To this point, we received a great patient question from Courtney, who asked us, “My biological mitral valve replacement is failing after ten years. Are there minimally invasive operations to re-replace the valve?”
To answer answer Courtney’s question, we connected with Dr. Junaid Khan, a leading cardiac surgeon at Alta Bates Summit Medical Center in Oakland, California. Dr. Khan specializes in minimally invasive techniques and has performed thousands of heart valve procedures while successfully treating many patients in our community. Here is what Dr. Khan shared with us at the 60th Annual Meeting of The Society of Thoracic Surgeons.
Key Learnings About Minimally Invasive Mitral Valve Re-Replacement
Here are important insights from Dr. Khan about minimally invasive mitral valve re-replacement:
- Courtney’s question is both common and complex. Khan said, “That’s a great question and one of the most common we get asked. Like with anything, the answer is a little complex. In some ways, the actual minimally invasive re-replacement is easier to do because we don’t have to take down all the scar tissue that was there from the first surgery. We also have techniques now where we can actually occlude the aorta from the inside with a balloon, so we have to do minimal dissections. Sometimes it can be harder depending on the amount of adhesions or scar tissue in the chest, but we can certainly do it and do it relatively routinely.”
- Performing a minimally invasive re-replacement depends on the risk profile. Khan stated, “The most interesting thing I would tell Courtney is it depends on her age and risk profile.” He told us that they can and often do regular mitral valve re-replacements through a catheter in certain patients. “Transcatheter mitral valve replacement, along with my cardiology colleagues, we do on a relatively routine basis,” he said.
Thanks to Dr. Khan and Alta Bates Summit!
On behalf of Courtney and all of our HeartValveSurgery.com patients around the world, thank you to Dr. Junaid Khan for sharing his experience and insight into minimally invasive mitral valve re-replacement. We’d also like to thank his Alta Bates Summit Medical Center team for taking great care of our heart valve patients!
Keep on tickin!
Adam
Written by Adam Pick
- Patient & Website Founder
Video Transcript:
Adam: Hi everybody, it’s Adam with heartvalvesurgery.com. We’re in San Antonio, Texas at the annual meeting of The Society of Thoracic Surgeons. I am thrilled to be joined by Dr. Junaid Khan, who is a leading cardiac surgeon at Alta Bates Summit in Oakland, California. During his extraordinary career, Dr. Khan has performed thousands of heart valve procedures. Dr. Khan, you and I have known each other for over 10 years. It is great to see you again and thanks for being with us.
Dr. Khan: Adam, I think the service you provide for the community is so outstanding. There’s so many patients who come to us who have been inspired by your website and will actually have come to us with questions based on looking through your website.
Adam: Yeah, well, speaking of questions, we’re at this great conference, we’re learning a lot, fantastic meetings and presentations, and we have a patient question that just came in for us, Dr. Khan, that is right up your alley given your specialties in minimally invasive surgery. This comes in from Courtney and she asks, “My biological mitral valve replacement is failing after 10 years. Are there minimally invasive operations to re-replace the valve?”
Dr. Khan: Courtney, that’s a great question. Actually Adam, that’s one of the most common questions we get asked. Like with anything, the answer is a little complex. In some ways, the actual re-replacement minimally invasively is actually easier to do because we don’t have to take down all the scar tissue that was there from the first surgery. We also have techniques now where we can actually occlude the aorta from the inside with a balloon, so we have to do minimal dissections. Now, sometimes it actually can be harder depending on the amount of adhesions or scar tissue in the chest that we have, but we certainly can do it. We do it relatively routinely, and it is one of the most common questions we get asked. The most interesting thing I would tell her, it depends on her age and also depends on your wrist profile. Right now, we actually can in certain patients and do regularly replace the mitral valve in a situation like yours through a catheter. Transcatheter mitral valve, along with my cardiology colleagues, we do on a relatively routine basis.
Adam: Thanks for bringing in the whole TMVR (transcatheter mitral valve replacement). Dr. Khan on behalf of Courtney, on behalf of all the patients at heartvalvesurgery.com, patients all over the world, thanks for everything you and your team are doing at Alta Bates Summit in Oakland, California. Thanks for being with me.
Dr. Khan: My pleasure, Adam.
