Center of Cardiovascular Surgery and Interventional Cardiology
at the N.I. Pirogov Clinic of High Medical Technologies of St. Petersburg State University
Center of Cardiovascular Surgery and Interventional Cardiology
at the N.I. Pirogov Clinic of High Medical Technologies of St. Petersburg State University
Cardiac Surgery · Saint Petersburg
Replacement of the aortic, mitral, and tricuspid valves through a mini-access — without full sternotomy
Performed free of charge under CHI and federal quotas
A patient shares their experience of minimally invasive heart valve replacement at Pirogov Clinic
Minimally invasive valve replacement is the replacement of a diseased heart valve through a reduced access of about 5–7 cm, without full sternotomy. The surgical technique itself is the same as in classic surgery, but tissue trauma is significantly lower. The method has been used since the mid-1990s.
At the Center for Cardiac Surgery of the N.I. Pirogov VMT Clinic, SPbSU, this technique is used to replace the aortic, mitral, and tricuspid valves.
5–7 cm
incision length
2.5–3 hours
surgery duration (aortic valve)
No sternotomy
chest wall structure preserved
Faster
activation and rehabilitation
Acquired disease of the aortic, mitral, or tricuspid valve
The surgeon determines whether mini-access is possible based on height-weight parameters and comorbidities
The method is not used if the valve disease is combined with coronary artery disease requiring simultaneous bypass grafting
Mini-J Sternotomy
Used for aortic valve surgery.
Right Mini-Thoracotomy
Used for mitral valve surgery and/or an antiarrhythmic procedure (left atrial cryoablation, similar to the Maze procedure). Requires peripheral cardiopulmonary bypass — an additional incision of about 3 cm in the groin area to connect the bypass machine.
Neat cosmetic scar
Less pronounced pain
Early activation due to preservation of the chest wall structure
Reduced surgical trauma
Safety and outcomes comparable to classic surgery
Fewer early postoperative complications and shorter rehabilitation
The cardiac surgeon determines the choice of prosthesis individually.
Mechanical Prosthesis
Lasts a lifetime, but requires lifelong anticoagulant therapy (warfarin) under blood clotting control.
Biological Prosthesis
Does not require lifelong anticoagulation; average lifespan is 15–20 years depending on the patient's age.
Transcatheter Aortic Valve Implantation (TAVI)
Aortic valve replacement through an arterial puncture, without incisions — for patients with high surgical risk.
Learn moreCoronarography
Coronary artery evaluation before heart valve surgery.
Learn moreCoronary Artery Bypass Grafting
Surgical treatment of ischemic heart disease — for combined valve and coronary artery disease.
Learn moreAortic Prosthesis
Surgical treatment of aortic aneurysms and other aortic conditions.
Learn moreEarly activation due to preservation of the chest wall structure
Less pronounced pain contributes to faster recovery
Shorter rehabilitation period compared to classic surgery
The exact length of hospital stay and activation schedule is determined individually by the attending physician.
Minimally invasive heart valve replacement at Pirogov Clinic is performed free of charge under the CHI policy and federal high-tech medical care (HTMC) quotas — subject to indications and referral. Our administrators will help you arrange the quota and prepare the required documents.
Dmitriy Shmatov
Professor, Deputy Director for Medical Affairs (Cardiac Surgery), Head of the Department of Cardiovascular Surgery, St. Petersburg State University Medical Institute
Maksim Kamenskih
Head of the Cardiac Surgery Department with an office for X-ray endovascular diagnostics and treatment
Gleb Kim
Cardiovascular Surgeon
Alexey Filippov
Cardiovascular Surgeon
It is the replacement of a diseased heart valve through a small 5–7 cm incision without full sternotomy. The surgical technique is the same as in classic replacement, but tissue trauma is lower, so the patient recovers faster.
In classic surgery, the sternum is fully divided (full sternotomy). With a mini-access, a short incision is made and the chest wall structure is preserved. This results in less pain, a neat scar, and early activation, with safety comparable to classic surgery.
The aortic, mitral, and tricuspid valves. A mini-J sternotomy is usually used for the aortic valve, and a right mini-thoracotomy for the mitral valve.
The method is indicated for acquired valve disease. The surgeon assesses whether mini-access is possible based on height-weight parameters and comorbidities. It is not used if coronary artery bypass grafting is also required.
TAVI is aortic valve replacement using a catheter through an arterial puncture, without incisions, for patients with high surgical risk. Minimally invasive replacement is a surgical valve replacement through a small incision; it is suitable for the aortic, mitral, and tricuspid valves.
A mechanical prosthesis lasts a lifetime but requires lifelong anticoagulant therapy (warfarin). A biological prosthesis does not require lifelong anticoagulation but lasts an average of 15–20 years. The choice depends on the patient's age and condition and is determined by the cardiac surgeon.
Aortic valve replacement usually takes 2.5–3 hours. The exact time depends on the valve, the access used, and individual patient factors.
No. The incision is only about 5–7 cm, so the cosmetic result is noticeably better than after full sternotomy. For mitral valve access, an additional small incision of about 3 cm in the groin area may be needed.
Because the chest wall structure is preserved, the patient is activated earlier and rehabilitation is shorter than after classic surgery. The exact length of hospitalization and recovery is determined individually by the attending physician.
With a mechanical prosthesis, lifelong anticoagulant therapy (warfarin) is required under blood clotting control. With a biological prosthesis, lifelong anticoagulation is generally not required.
A mechanical prosthesis is designed to last a lifetime. A biological prosthesis lasts an average of 15–20 years depending on the patient's age and condition; it can be replaced when worn out.
Minimally invasive replacement is a well-established method with outcomes comparable to classic surgery, and the rate of early complications is in most cases lower. Like any cardiac surgery, it carries risks, which are minimized by an experienced surgical team.
At Pirogov Clinic, the surgery is performed free of charge under the CHI policy and federal high-tech medical care quotas, subject to indications and referral.
A referral and confirmed indications are required. Book a consultation — our specialists will assess your case and help you arrange the quota (HTMC) and prepare the necessary documents.
Before surgery, echocardiography, coronarography, and other studies are performed to assess the valve disease and select the prosthesis and access. The exact preparation plan is drawn up by the attending physician during the consultation.
Book an online talk or get in touch with our administrators. We'll help you choose the right specialist, answer any organizational questions, and explain how to prepare for the consultation.