NEW TECHNIQUES REDUCE PAIN, RECOVERY TIME FROM HEART OPERATION.

Byline: Rebecca Goldsmith Cox News Service

A new approach to an old procedure is saving patients much of the pain and some of the recovery time common to heart valve replacement surgery.

Since open heart surgery began in the 1950s, doctors have reached the heart with a long vertical cut through the breastbone, enabling them to pry open the rib cage.

Techniques pioneered in the last six months feature shorter incisions, sometimes altogether avoiding bone.

Last month, Drs. Kenneth Begelman and Jeffrey Newman performed the first minimally invasive valve replacement in Florida's Palm Beach County at Delray Community Hospital.

Their patient, Ralph Nathan, 66, of the Huntington Lakes community west of Delray Beach, discovered that he needed the procedure after losing his breath during a tennis game.

His doctors cut a 4-inch vertical incision in his breast bone. Instead of separating his ribs, they cut laterally into surrounding cartilage to get a better view of his heart.

Nathan was out of the hospital's intensive care unit in two days, one day less than with the usual procedure. And his entire hospital stay is expected to be six days instead of the usual eight.

The back and rib pain that results from separating the rib cage also is reduced with the new procedure.

Dr. Carl Gill, of the Cleveland Clinic in Fort Lauderdale, performed Florida's first minimally invasive valve replacement in March with a slightly different technique that avoids the breastbone but sacrifices an internal mammory artery.

About 40,000 Americans undergo heart valve replacement surgery each year.