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Heart valves

Gentle heart surgery with the DaVinci robot

Gentle heart surgery with the DaVinci robot

The "surgeon with the four arms" does not tremble once while taking a part of the Arteria mammaria interna, a small arterial branch in the chest cavity, for a bypass supply with high-precision movements.

At the control console of the DaVinci surgical robot sits Prof. Dr. med. Jürg Grünenfelder, specialist in cardiac surgery and head of cardiac surgery at HerzKlinik Hirslanden in Zurich/Switzerland.

Heart valve surgery

Heart valve surgery

Catheter-based heart valve therapy is performed without opening the chest and using the heart-lung machine on the beating heart.

Many patients who have had heart valve surgery describe the procedure as very stressful. In many cases, neither of these procedures is necessary, explains Prof. Dr. med. Jürg Grünenfelder.

A robot for the heart

Thanks to robot support, defective heart valves can be repaired more gently than ever before. Now also in Switzerland.


Prof. Jürg Grünenfelder (in conversation with doctor Stutz)

Barely out of the operating room and already back on my feet.

Prof. Dr. med. Jürg Grünenfelder

Prof. Dr. med. Jürg Grünenfelder

Most heart valve operations are performed on the open heart. The rib cage is cut open, the sternum is spread, the heart is exposed. But the risk of such an operation is all the greater the worse the patient is. For very weak patients, who suffer from many secondary diseases, conventional surgery is therefore associated with more complications and a higher mortality rate. This is why the minimally invasive method is used for them, where surgery is performed through a tiny hole. Even younger or otherwise healthy heart valve patients are increasingly opting for this new technique because it enables them to get back on their feet and resume their everyday work much faster.

Prof. Dr. med. Jürg Grünenfelder from the Hirslanden Heart Clinic in Zurich goes one step further. For the first time in German-speaking Switzerland, they are using a robot to perform minimally invasive procedures on the mitral valve. What are the advantages? "Thanks to robot technology, the surgeon sees the small operating field three-dimensionally and magnified tenfold.

The access is smaller than with the normal minimally invasive method, and the ribs are not spread at all. Teamwork is required. Prof. Grünenfelder operates the Da Vinci robot and focuses on the surgical intervention. I stand directly at the operating table and support him. We can see much more and much more clearly in the chest area because the robot works with tiny instruments. Thanks to the precise robot technology, defective heart valves can be preserved and repaired even if they would have had to be replaced long ago using the conventional method. And every heart specialist knows that it is much better to repair a heart valve than to replace it.

Higher requirements than for normal surgery

Grünenfelder acquired knowledge about the new robot technology from colleagues in New York and Brussels. And after thorough examination, the decision was made to offer this type of heart surgery in Zurich at all. "The demands on the surgical team are higher than for a normal operation. It requires a great deal of dexterity and practice, coupled with great experience," says Prof. Jürg Grünenfelder. "This is truly top-class medicine. Once you've done it this way, you don't want to work without a robot. It's really worth it. And the results are impressive. A few weeks ago, we operated on an 83-year-old woman on the mitral valve. After the gentle intervention with the Da Vinci robot, she got up the very next day and walked around. On the fifth day she said she felt very well and wanted to go home. It is almost like a miracle. People who could barely climb stairs before the operation blossom again completely in a very short time."

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Heart valves?

Replace heart valves without opening the chest


Prof. Dr. med. Roberto Corti and Prof. Dr. med. Georg Noll

Prof. Dr. med. Georg Noll

Prof. Dr. med. Georg Noll

Heart valve diseases are often discovered only by chance and are dangerous, even fatal, if left untreated.

When the physical performance decreases, one should be alert and not think that this is part of the normal aging process.

Heart valves are like sluices in the heart that open and let the blood through. However, in the course of life the heart valves wear out. This can lead to calcium deposits. This narrowing prevents the blood from flowing through properly.

If medication does not help sufficiently, the heart valves must be replaced. Sometimes, however, older patients are plagued by several diseases, are weakened and cannot be operated on. Exactly for these patients there is a gentle method to replace the heart valves without opening the chest. "Health Today" takes a closer look and wants to know whether this newer technology delivers what it promises.

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Heart valve repair with MitraClip

Heart valve repair with MitraClip


Prof. Dr. med. Roberto Corti

Prof. Dr. med. Roberto Corti

Prof. Dr. med. Roberto Corti

Great difficulty in breathing and water in the lungs. The reason was a defective heart valve. Because he had already had several bypass operations and a heart attack, open heart surgery was no longer an option.

The doctors decided on an alternative, the so-called MitraClip method. Using the latest technology, the minimally invasive procedure was performed in the new hybrid operating theatre at the Hirslanden Clinic.

Prof. Dr. med. Roberto Corti and Prof. Dr. med. Jürg Grünenfelder during an operation