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Robot aids minimally invasive heart valve repair

Methodist Hospital photo

A team at the Methodist DeBakey Heart & Vascular Center, in Houston, led by heart surgeon Dr. Gerald Lawrie has been using a surgical robot to perform a minimally invasive procedure during which the mitral valve of people suffering from Barlow's disease is repaired rather than replace with a mechanical valve. Lawrie is at upper right operating a DaVinci surgical robot.

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SUNCOAST NEWS STAFF REPORT

Published: October 13, 2009

Updated: 10/13/2009 03:39 pm

Although the pioneering namesake of the Methodist DeBakey Heart & Vascular Center passed away 16 months ago, heart surgery innovation is still going on at the Houston medical center.

Heart surgeon Dr. Gerald Lawrie has been using a surgical robot to repair the mitral valves of people suffering from Barlow's disease. With the robotic assist, Lawrie can perform the valve repair through three small incisions.

The standard surgical treatment for Barlow's disease involved replacing the mitral valve through a large incision.

In Barlow's disease, also known as idiopathic mitral valve prolapse, the malfunctioning mitral valve allows blood to flow back into the heart's left atrium from the left ventricle. The left ventricle is supposed to pump oxygen-rich blood into the aorta, the body's main arterial trunk.

Although Barlow's disease normally is a relatively minor disorder, it can prove life threatening in a limited number of severe cases. The backflow of blood through the malfunctioning mitral valve can lead to damage of both the left atrium and the lungs.

In the techniques he is developing, Lawrie uses a DaVinci surgical robot to reshape and reposition the pair of leaflets that make up the mitral valve. The standard procedure involves replacement of the mitral vale, also known as the bicuspid valve, with a mechanical substitute.

The large incision used during the standard procedure can lead to a longer and more painful postsurgical recovery. Patients with artificial heart valves have to take medicines to keep potentially deadly clots from developing around them.

"Using this new technique, we restore the patient's own valve, preventing the need to replace it with a mechanical valve that will require lifelong blood thinner medications for the patient," said Lawrie, who holds the Michael E. DeBakey Endowed Chair for Cardiac Surgery at The Methodist Hospital, in Houston.

So far the robotic procedure has had a 100 percent success rate.

Lawrie reports on the procedure in an article published in the September issue of the journal Annals of Thoracic Surgery.

Lawrie was in the headlines in March, when he replaced the aortic valve of former first lady Barbara Bush.

A native of Australia, Lawrie arrived in Houston in 1974 and completed a fellowship in cardiovascular surgery at the Baylor College of Medicine. He then received an invitation to join the surgical staff of Dr. Michael E. DeBakey, with whom he was professionally associated for more than two decades.

DeBakey and an army of his former protégés and associates have pioneered many of the heart surgery procedures in use today. DeBakey's innovations include coronary bypass surgery, the use of artificial grafts to replace or repair damaged blood vessels and the first use of an artificial pump to assist diseased left ventricles.

In 2005, at the age of 97, DeBakey was involved in another bit of surgical trailblazing when he became the oldest person to undergo and survive the repair of a ruptured aortic aneurysm. Decades earlier, DeBakey developed the procedure surgeons used to repair his torn aorta.

DeBakey, the son of Lebanese immigrants, never retired from the practice of medicine and was still performing a limited number of surgical procedures into his mid-90s. He died in July 2008 of what were called natural causes. He would have turned 100 on Sept. 7, 2008.

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