I'm being evaluated for heart surgery. specifically an aorta heart valve replacement and possibly surgery for an enlarged aorta measuring 5.1 cm. would the combination of the above preclude me as a candidate for minimally invasive surgery or would the tr

This surgery is: Currently best performed open heart. Minimally invasive surgery will not adequately address the aorta.

Yes: Minimally invasive surgery is not the best option when it comes to repair of an aortic aneurysm.

Depends: On the technology and skill of the surgeon and medical center where you go. Both procedures can be done percutaneously/endovascular by entering the vessels in your groin. Whether both can be done at the same time is something only your surgeon/cardiologist should discuss with you. Minimally invasive valve surgery is usually done for pts who would not be able to tolerate an open procedure.

Too complex: This is an extremely complex issue that needs face to face evaluation and discussion.

Minimally invasive: Current minimally invasive approaches do not address correction of your significant sanding aortic aneurysm. Standard open heart surgery would address both.

It depends. : In general, combined aortic valve-ascending aortic aneurysm procedure is done by opening the chest thru the breast bone. This is the safest and most reliable route to take. On the other hand, if the risks are high, alternative routes like minimally invasive procedures can be resorted to, so long as the surgical team has expertise. If the risks are prohibitive, one may choose no operation.

Maybe: I perform minimally invasive mitral valve surgery and also aortic valve surgery. I personally have not done an aneurysm but do know of a couple of surgeons that do. One of the surgeons does it thru a partial incision of the breast bone. The other does it between the 2nd and 3rd ribs. It really depends on the extent of the aneurysm and how much if the aorta has to be repaired.

Upper sternotomy: An incision which opens only the upper portion of the sternum could give enough access for the surgery you need. This would be best evaluated by someone who does this type of approach regularly.

Combination/complex: Your combination of aortic valve disease and ascending aortic aneurysm is complex. The info needed that is nearly impossible to obtain is the status/size of your aortic root, dilated or not dilated. Our team in spokane, would recommend open repair, of both problems when either problem meets criteria for repair. Perhaps your valve is not yet bad enough for replacement. Okay to wait on 5.1 cm aaa.

Maybe: Once the decision is made to formally recommend surgery to you, the surgeon should use the approach he is most comfortable with. Minimally invasive approaches are possible but most surgeons would approach this with a standard sternotomy.