Our heart is a unique engine that beats about 100,000 times a day and works nonstop. One of the silent heroes behind this flawless rhythm is the mitral valve.
Located between the left atrium and the left ventricle, this valve ensures that blood flows in the correct direction. When its function is impaired, symptoms such as shortness of breath, fatigue, palpitations, chest pain, and a significant decline in quality of life may occur.
For many years, mitral valve surgeries were performed by making a full-length incision in the sternum. Today, with advances in surgical technology and experience, it has become possible to access the heart through a much smaller opening. We call this method minimally invasive mitral valve surgery, and in most patients, it can be performed through a 6–8-centimeter incision made in the armpit.
What is the minimally invasive method?
In this method, the sternum is not cut. Access to the mitral valve is gained through a small incision between the ribs, without opening the sternum—commonly known as the “breastbone.” Valve repair or replacement is performed using specialized camera systems, retractors, and long surgical instruments.
As a result:
• the incision is small
• tissue trauma is reduced
• the recovery process is accelerated
Who is a suitable candidate?
The majority of mitral valve surgeries can be performed using the minimally invasive method. However, suitability must be assessed by a cardiac and vascular surgeon experienced in this field. Generally:
• patients with mitral valve stenosis or regurgitation
• patients whose heart and lung functions are suitable for surgery
• patients without additional heart conditions requiring sternotomy
may be candidates for this method. The final decision is made following a detailed examination and diagnostic tests.
The most important advantage: No sternotomy
The most significant advantage of this method is that:
• the sternum is not opened
• the sternum is not cut
As a natural result:
• postoperative pain is significantly reduced
• the risk of infection and bleeding decreases
• deep breathing and movement become easier
• the recovery process is accelerated
• the patient returns to daily life sooner
It also offers a significant cosmetic advantage, particularly for young patients and women. This is because the surgical scar remains within the underarm creases and is difficult to notice from the outside.
Repair or Replacement?
Our primary preference is to preserve the valve by repairing it. However, in some cases where the valve tissue is severely damaged, valve replacement is necessary. Metal and biological valve options are available. When making a selection, the following factors are evaluated together:
• the patient’s age
• comorbid conditions
• the need for blood thinners
• lifestyle and expectations
The postoperative process is as follows:
Thanks to the minimally invasive technique:
• patients get out of bed sooner
• breathing exercises are easier to perform
• the hospital stay is shorter
• the return to work and social life is faster
It is important to emphasize the following:
This method is not a “minor surgery.” Major surgery is performed through a small incision. The severity remains the same; the trauma is reduced.
Final Thoughts
Cardiac surgery is advancing not only through smaller incisions but also through more refined techniques. Minimally invasive mitral valve surgery performed through the armpit is a powerful reflection of the philosophy of “more benefit with less trauma.” As a surgeon who has been working in this field for many years and performing these procedures, I observe that, in suitable patients, this method provides significant comfort both physically and psychologically.
The essence of this approach is as follows:
• Performing the surgery without opening the sternum
• Minimizing the physical strain on the patient
• Treating the heart and surrounding tissues gently
• Accelerating recovery by reducing pain and bleeding
• Helping the patient return to their daily life and work more quickly
If you have any symptoms, consult a cardiologist or a cardiac and vascular surgeon without delay. Rely on your doctor’s in-person evaluation, not on random information found online. Your heart works for you your entire life; taking care of it is the most valuable gift you can give to your health.
