Physicians at the University of Rochester Medical Center are pioneering a new approach to aortic valve replacement surgery that allows surgeons to confirm the quality of the procedure in real time and enables patients to recover more quickly.
Peter A Knight, M.D., the Majorie B. Morris Endowed Professor in Cardiac Surgery at URMC has conducted the procedure, called video-assisted minimally invasive aortic valve replacement, in more than 100 people and believes it will be transformative for the health care system and for patients. He presented several patient case studies demonstrating the safety and feasibility of the operation at the 30th annual meeting of the European Association for Cardio-Thoracic Surgery in October.
The surgery is needed when the aortic valve is unable to open fully and less blood exits the heart, or when the valve is leaky. Typically, physicians open the chest to conduct the operation, but Knight uses a small incision in the chest wall and a tiny video camera on the end of flexible tube to guide the procedure.
“With this minimally invasive approach patients have shorter stays in the intensive care unit and we don’t have to place the same limitations on people as when we open the whole chest,” said Knight, a member of the UR Medicine Heart & Vascular team. “The value of the camera is that you can see everything much better and make sure you’ve placed the new valve and sutures to hold the valve exactly where you want them. It allows for quality control right there in the operating room.”
Knight says that minimally invasive aortic valve replacements are being done in very few places around the world and to his knowledge URMC is the only institution performing the minimally invasive video-assisted procedures. He now conducts all heart valve procedures using this technique. Physicians from across the country are traveling to Rochester to meet with Knight and observe the procedure so that they can implement it at their home institutions and extend the benefits to more patients.
Knight collaborates on research projects with Jude Sauer, M.D., a former assistant professor at URMC who now leads medical device company LSI Solutions. Sauer suggested the use of the video camera to improve the surgery and Knight practiced and refined the procedure on cadavers before bringing it to patients.