iSVR: Intercostal Surgical Valve Replacement at UPMC in Central Pa.

The cardiovascular specialists at UPMC Heart and Vascular Institute perform iSVR, a minimally invasive procedure that treats conditions of the aortic, mitral, and tricuspid valves.

Why choose UPMC Heart and Vascular Institute for iSVR?

Our cardiovascular specialists are some of the most experienced in the region and began performing the iSVR procedure in 2014 to treat aortic valve disorders. Since then, our skilled surgeons have complete hundreds of iSVR procedures with excellent outcomes.

What is iSVR?

iSVR is a minimally invasive procedure that treats conditions of the aortic, mitral, and tricuspid valves. Using the iSVR approach, your surgeon can access your valves through the intercostal space between your ribs using a one-and-a-half-inch incision in your chest — without cutting your breastbone. Our surgeons use iSVR for several procedures, including:

• Aortic valve replacement
• Mitral valve repair/replacement
• Double valve repair/replacement
  • Mitral and tricuspid valves
  • Mitral and aortic valves
  • Some coronary artery bypass graft (CABG) surgeries

Traditional open-chest valve replacement procedures usually require large incisions and/or the division of major muscle groups, ribs, and cartilage. In addition to causing less trauma to the body, iSVR offers several benefits, including:

• Excellent cosmetic results
• Quicker recovery
• Less time in the intensive care unit (ICU) and hospital
• Lower chance of blood transfusion

How is the iSAVR surgical procedure different from traditional procedures?

Traditional Procedures:

Traditional Sternotomy

A traditional sternotomy includes a vertical incision along the sternum in which the sternum is divided or "cracked" itself.

Mini Sternotomy

The breastbone is cut to the fourth interspace and then closed using stainless steel wires at the end of the procedure.

RAT: Right Anterior Thoracotomy

A small incision is made on the anterior chest with division of major chest muscle, rib/cartilage, and right internal mammary artery (RIMA). It requires closure using steel plate or wires for the rib/cartilage.

iSVR Minimally Invasive Approach

• ½ incision laterally on chest
• Access obtained via intercostal (between ribs) space
• Does not require cutting:
  • Ribs
  • Cartilage
  • Pectoralis major muscle
• Preserves right internal mammary artery (RIMA)
• Perform iSVR for:
  • Aortic valve replacement
  • Mitral valve repair/replacement
  • Double valve repair/replacement
    • Mitral & tricuspid valves
    • Mitral & aortic valves
• Some coronary artery bypass graft (CABG) surgeries

What happens during iSVR?

You will be positioned on a table and placed under general anesthesia. You will be connected to a heart-lung bypass machine that will take over the function of your heart and lungs during your operation.

Your doctor will make a one-and-a-half-inch incision in your chest and access your heart through the intercostal space between your ribs. Your doctor will then perform your valve repair or replacement.

What can I expect after iSVR?

When your heart valve procedure is completed, you will be moved to recovery for observation and monitoring. Your doctor will provide more information about your recovery and your hospital stay.

How long does it take to recover after iSVR?

Your doctor will provide more information about your recovery after iSVR and will let you know when you can resume your normal activities. When compared to traditional open-chest surgery, patients who have an iSVR procedure typically experience less pain, have a shorter hospital stay, and recover more quickly. However, you should follow your doctor's instructions and go to all of your follow-up appointments.

Need more information?

Contact the Valve Clinic at: 1-855-275-6478

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Our Providers

• Mubashir A. Mumtaz, MD

Our Locations

UPMC Heart and Vascular Institute
Located at Brady Building
205 South Front Street
4th floor
Harrisburg, PA 17104
Phone: 717-231-8555
Fax: 717-231-8568