Minimally Invasive Mitral Valve Repair Marks a First for CHRISTUS in Longview

James Timmons was about to have his knee replaced.

The last step was to have a medical team examine his heart to ensure he was fit for surgery. Joint replacement surgery, such as knee replacement, carries a risk of cardiovascular problems primarily because of the stress it places on the body.

During his health check, James learned from his cardiologist that he had a leaky valve in his heart. He could even see the valve in question on an ultrasound.

“My first thought was, they’re going to have to do heart surgery,” James said. “They’re going to have to break open my chest. And my wife cried.”

James, however, qualified for a new procedure offered at the CHRISTUS Good Shepard Heart and Vascular Institute in Longview. James became the first patient in Longview to undergo minimally invasive surgery to repair the valve.

Repairing the Valve

When a valve in the heart fails to close tightly enough, it causes blood to flow back into the heart. Mitral valve regurgitation is the most frequent type of heart valve disease, and it occurs when the mitral valve is the source of the leakage.

The heart functions as the cornerstone of the circulatory system. It has four primary chambers: two ventricles and two atria.

The heart pumps blood regulated by four valves. Among these, the mitral valve acts as a critical gateway, controlling blood flow between the left atrium and the left ventricle.

Mitral valve regurgitation emerges as the most common form of heart valve disease, occurring when the mitral valve fails to seal tightly. This causes blood to backflow into the heart chamber.

Dr. Lisardo Garcia, MD, Chief of Cardiothoracic Surgery at CHRISTUS Good Shepard, emphasizes the significance of valve repair, advocating for a minimally invasive approach whenever possible.

“When you're dealing with mitral valve disease, ideally, you should try to repair those valves,” Garcia said. “We usually try to fix the valve. But in reality, very few surgeons in the country repair valves with a minimally invasive approach.”

Instead of opening his chest for open heart surgery, his doctor performed a less invasive procedure that repaired his valve, something uncommon in areas outside of large cities.

Specializing in cardiothoracic surgery, Dr. Garcia brought to Longview a level of expertise typically reserved for major metropolitan hospitals.

Mitral Valve Repair Surgery

Mitral valve repair surgery is a complex medical procedure designed to correct issues with the mitral valve, one of the four valves in the heart.

If left untreated, the condition can lead to fatigue, irregular heartbeat, and shortness of breath. However, sometimes there are no symptoms until conditions of the heart become more severe. 

In traditional open-heart surgery, surgeons access the heart by cutting through the breastbone, or sternum, and opening the rib cage. This approach is known as a sternotomy.

However, through a minimally invasive surgical technique, the mitral valve is repaired through a small incision between the ribs and without cutting through any bone, reducing trauma and potentially leading to a shorter length of stay at the hospital and an overall faster recovery.

Surgery may be used to repair the anatomy of the vale, which can include tightening or replacing the ring around the valve, reshaping the valve leaflets to improve closure, or removing excess tissue.

Candidates for Valve Repair Surgery

Not all mitral valves can be repaired; sometimes, a replacement is necessary. Your surgeon can explain the preferred treatment; not everyone can have a minimally invasive procedure.

What matters is what is best for the patient. Dr. Garcia said the Heart and Vascular Institute works across departments to determine the best treatment for each patient.

“Every week, our team of interventional cardiologists, clinicians, and surgeons gets together to discuss how each individual case should be approached,” said John McClish, MD, and Chief of Cardiology at the Heart and Vascular Institute in Longview.

“We make decisions based not on one person but as a team approach, and that's the approach used in top institutions.”

Recovery From Valve Repair Surgery

James was in the hospital for five days after the surgery for routine care and monitoring. Before leaving, he needed to show the doctors that he could walk around the hospital unit without losing his breath.

“I wouldn’t even know I had heart surgery if it wasn’t for the scar; it was just amazing,” James said. “I was amazed how little effect it had on me.”

James said once he was out, he would get short of breath walking to his pond on his five-acre lot where he lived in the country. But soon, he could walk to the pond if he didn’t overdo it. Within about two weeks, he was driving again.

James encouraged anyone facing minimal invasive valve repair surgery not to worry.

“To me, the knee surgery is harder than this surgery on my heart.”