Minimally Invasive Heart Valve Replacement

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.