Mitral Valve Surgery

Minimal Access or key-hole Mitral Valve Repair or Replacement

Mr Casula began keyhole and minimal access mitral operations in 2003, setting the UK safety standards for these procedures over 20 years ago.

He has led the Minimal Access Heart Valve Programme at Hammersmith Hospital, Imperial College Healthcare Trust, since its creation in 2011 and has successfully carried out the largest number of these successful keyhole operations since at both the Hammersmith Hospital and private sector hospitals in London.

Traditionally, surgical interventions for mitral valve disorders are carried out via a large and traumatic chest opening, such as a full median sternotomy, which could be too traumatic in elderly or frail patients, resulting in many days spent in the hospital, significant postoperative bone-related discomfort, and long recovery times to return to normal daily activities. These traditional operations also result in patients with large, visible chest scars.

Minimal access and keyhole techniques are a less invasive alternative to traditional surgery opening the full breast bone and with outstanding surgical results and outcomes. These are currently offered by a limited number of very experienced cardiac surgeons, such as Mr Casula.

Minimal access Mitral valve repair, also known as minimally invasive or keyhole mitral valve repair, involves accessing the heart through small incisions, typically in-between the small space between the two ribs. The small scars are located underneath the breast and, as a consequence, result in an ideal cosmetic appearance, particularly in female patients.

These approaches prevent the need for extensive sternal bone fractures or thoracotomies, reducing surgical trauma and postoperative pain. Consequently, patients undergoing minimal access mitral valve repair often experience shorter hospital stays, and in Mr Casula’s personal experience during the past 20 years, this has resulted in faster recovery times, reduced needs for blood transfusion, and reduced overall complications compared to those undergoing traditional open-heart surgery.

Moreover, the precision afforded by minimally invasive techniques facilitates targeted interventions, ensuring optimal repair of the mitral valve while preserving surrounding cardiac structures. By minimising surgical trauma and intracardiac collateral trauma and preserving physiological integrity, minimal access approaches mitigate the risk of postoperative complications, such as bleeding, infection, and wound dehiscence.

To arrange a consultation with Mr Roberto P. Casula, please contact Mr Casula’s medical secretary on 0203 423 7498, or Cardiac Bookings team on 0203 423 7500, or via email at rcasulamedsec@ccf.org.