Minimally-Invasive Heart Surgery Offers Less Pain, Faster Recovery

Steve Maatman knew he was having heart trouble when he came to us for a consultation but he wasn't expecting his wife to be diagnosed with a similar condition during his appointment.

Steve was referred to Mario Castillo Sang, MD, because of a leak in one of his heart valves, known as the mitral valve. Traditionally, repair or replacement of this valve has required conventional open-heart surgery. But thanks to a program specializing in minimally invasive mitral heart operations, launched by Dr. Castillo Sang in 2016, both Steve and his wife Lynn Maatman had a better option.

While we were in the office Dr. Castillo Sang was asking questions like: 'Do you get out of breath walking up the steps?' and I said 'No, I don't,' but I looked at my wife. She was the one who got out of breath, so before we left he wound up examining her as well, Maatman says.

As it happened, Lynn also had a mitral valve condition. Hers had proved difficult to diagnose because the symptoms she experienced during exercise didn't show up in previous testing.

"I went to a cardiologist in May and he said: 'You have a mild mitral leak. I'll see you in three months and we'll do a baseline echo and keep track of it.' But the shortness of breath didn't change," Lynn Maatman says. "When we were talking to Dr. Castillo Sang it came out that I would have to sit down and rest after two flights of steps. At that point he encouraged me to get a second opinion."

Joel Reginelli, MD, eventually resolved the issue by asking Lynn to lift a pair of two-pound weights during her angiogram. "As soon as I started doing that my blood pressure spiked and he said to his assistant 'well there it is,'" she says. That led to another test, which identified valve leaks that hadn't yet been diagnosed.

While Lynn's heart issues differed from her husband's,  both eventually received minimally-invasive treatment from Dr. Castillo Sang.

First developed in Leipzig, Germany, in 1998, the "mini mitral" heart procedure requires only two small incisions, one for a camera and instrumentsand the other for a heart/lung machine. The largest incision is approximately two inches on the right side of the chest, and is easily concealed after surgery.

"This is still open-heart surgery, yet the way we get to the heart is so much less invasive that the impact to the body is very different. We don't cut or crack a rib ," Dr. Castillo Sang says.

Dr. Castillo Sang's program is one of the few in the United States that specializes in this procedure. Patients typically report significantly less pain and faster recovery.

"Many of my patients never fill their narcotic prescriptions when they go home," Dr. Castillo Sang says.

"It was really great that I didn't have to have my sternum (breast bone) cut or broken, because you lose so much upper body strength when they do that," Steve Maatman says.

"I wish Steve hadn't had to go through it, but I'm thankful I was with him when he went to see Dr. Castillo Sang," Lynn Maatman says. "You really have to listen to your body, and when you see something significant happen you really need to take action and keep pursuing until you find an answer. I don't think it ever hurts to have a second opinion."

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