In the Sechenov University of the Ministry of Health of the Russian Federation, one of the most complex and rare heart surgeries was performed – the mini-invasive David operation. The story of the patient and the intervention itself was told by Roman Komarov, a cardiothoracic surgeon, professor, and director of the clinic of cardiovascular surgery at Sechenov University of the Ministry of Health of the Russian Federation.
The patient Denis Kondratyev‘s medical history spans over 15 years. He first learned about his aorta’s altered diameter. Throughout this time, doctors monitored the issue but decided not to operate until the defect reached critical parameters. Nevertheless, for the past fifteen years, Denis mentally prepared himself for the surgical intervention.
Access through 4 cm
“Unfortunately, time took its toll – within a year, the diameter of my aorta increased by more than 10%,” says Denis Kondratyev. “I started looking for a clinic to perform the operation. Since my job involves active travel around the world and I spend a lot of time on trips, I cannot afford to be on sick leave for a long time.”
The patient required the reconstructive David operation, which involves the re-implantation of the patient’s own aortic valve into a prosthesis in the ascending aorta. The majority of these operations are performed with a standard sternotomy approach. The unusual method implies that the operation is carried out by sawing the chest, which not only means pain for the patient but also a very lengthy rehabilitation period with no physical activity possible in the months following the surgery.
The clinic of cardiovascular surgery at Sechenov University specializes in mini-invasive cardiac surgery, so given the patient’s work demands, the decision was made to perform the David operation on him in a minimally invasive way. “During the mini-invasive David operation, the access is only 4-5 cm,” comments Professor Roman Komarov. “The patient only spends a few days in the hospital, and after the intervention, he will not need any rehabilitation or even take any medication – the operation ensures full recovery and a completely normal quality of life.”
Life doesn’t wait
The patient was discharged from the clinic after 5 days. “I will complete the remaining recovery work at home and plan to start a new interesting project in North Africa soon,” shares Denis Kondratyev about his plans.
According to Professor Komarov, the mini-invasive approach is proving increasingly effective in Russian cardiac surgery today, where access to the patient’s heart is done without breaking the sternum. “The reduction in risks of postoperative complications, reduced pain syndrome, and significant reduction in the rehabilitation period are all undeniable advantages of modern minimally invasive cardiac surgery,” concludes Roman Komarov.