The Harley Street Clinic
35 Weymouth Street W1G 8BJ London
Endoscopic cardiac surgery for mitral and aortic valves
Less invasive, minimal access surgical technique as an alternative for open heart surgery (sternotomy). The technique provides more options for patients and can help them achieve a better quality of life more quickly, along with less pain and scarring.
Endoscopic cardiac surgery is a minimally invasive procedure to treat a wide variety of heart valve conditions, coronary artery disease, PFO and Atrial Fibrillation. Due to a smaller incision, it allows for less scarring, faster recovery time and less complications for patients. The procedure involves high-definition 3D cameras and screens to aid collaboration for greater accuracy and quality.
The Harley Street Clinic, part of HCA UK, is the only private hospital in the UK that offers totally endoscopic valve repair for the mitral and aortic valves and is leading the way in the endoscopic cardiac surgical field.
The table below outlines the main differences between open-heart surgery (a sternotomy) compared to endoscopic surgery:
| Open-heart surgery (sternotomy) | Endoscopic heart surgery |
|---|---|
| 15-20cm incision | 2.5cm incision |
| Scarring down the centre of the chest | Minimal or non-existent scarring |
| 4–6-month recovery time | 3-week recovery time |
| Relies on direct vision | Multiple 3D screens for better accuracy |
| Post-surgery back and chest pain | Minimal discomfort post-surgery |
Examples of scarring from standard heart surgery and endoscopic heart surgery
Sternotomy post-surgery scar
Endoscopic surgery scar
Speaking about the new mitris resilia mitral valve we now offer as part of our endoscopic cardiac procedures, Mr Bahrami said:
“This procedure is life changing for the patient. Younger patients who usually receive a metallic valve will experience some troublesome noise from the valve. The resilia valve is made from tissue and therefore not noisy, it also offers less risk of infection and avoids the need for a repeat operation as the valve will last up to 20-30 years. The durability is almost 10 times better. The Harley Street Clinic is the only private hospital in the UK that offers totally endoscopic valve repair for the mitral and aortic valves and is leading the way in the endoscopic cardiac surgical field.”
What procedures can be performed with endoscopic cardiac surgery?
- Coronary artery bypass / MIDCAB
- Mitral valve repair/replacement
- Aortic valve repair/replacement
- Tricuspid valve repair/replacement
- Left atrial appendage occlusion and atrial fibrillation ablation
- Patent foramen ovale (PFO) closure
- Atrial septal defect closure
Conditions we treat
- Mitral valve disease
- Aortic valve disease
- Tricuspid valve disease
- Coronary artery disease
- Patent foremen ovale (PFO) - hole in the heart
- Atrial fibrillation – irregular heartbeat
What you can expect
You will discuss your medical history and symptoms with the consultant, and they will arrange imaging or diagnostic tests, and involve allied specialists if required (e.g. imaging cardiologists, interventional cardiologists, radiologists, pre-assessment team and clinical nurse specialists).
Most of the time, you will complete your cardiac invasive and non-invasive assessments and imaging during the same week and receive your results within 48 hours. Tests include:
- Echocardiogram (Transthoracic/Transoesophageal)
- Angiogram
- CT with 3D reconstruction
- Chest x-ray
- Blood tests
Your case will be presented to the specialised dedicated cardiac multidisciplinary team, who hold regular meetings to ensure the highest level of best medical practice based on GMC guidelines.
Having endoscopic surgery means you’ll be under general anaesthetic for around 3-4 hours. A small incision of 2.5cm will be made and the surgery will be carried out using cutting-edge technology including 4K 3D camera system with robotic arm and specific endoscopic instruments, which allows a higher level of precision and better quality of repair. For men the incision is made at the peri-areola area or on the right side of the chest; for women, it’s made at the peri-areola or underneath the chest. Once surgery is complete, small stitches will be made at the incision site to ensure minimal scarring.
As a patient you will be supported throughout your journey by our one-to-one dedicated cardiac clinical nurse specialist. Immediately post-surgery you will be monitored in the intensive care unit for up to 2 days before moving to the cardiac ward of the hospital, where you will stay for around 3 days to recover. Our cardiac CNS will conduct a post discharge call within 1-3 weeks and update your consultant (you can contact them at any time – given a number). The consultant will also see you 2 weeks post-surgery at one of their NHS or private outpatient clinics.
Examples of minimal scarring from endoscopic cardiac surgery
Example of scarring with endoscopic keyhole heart surgery on female (peri-areola)
Example of scarring with endoscopic keyhole heart surgery on male (right side of chest)
Why The Harley Street Clinic?
✓ Specialists in endoscopic/minimally invasive heart surgery – The Harley Street Clinic was the first private hospital to perform MITRIS RESILIA valve replacement (aortic and mitral), endoscopic mitral and tricuspid valve surgery.
✓ We work with the leading consultant in endoscopic cardiac surgery, Mr Toufan Bahrami who has performed over 1,500 minimal access cardiac surgeries.
✓ The Harley Street Clinic performed over 100 minimally invasive/endoscopic cardiac procedures in the last year.
✓ We are the only private hospital offering endoscopic heart surgery in the UK.
✓ We invest in market leading, innovative technology to ensure the best patient outcomes.
✓ A personalised approach to care for every patient, considering their individual anatomy, surgical preferences and lifestyle.
✓ Current waiting times for endoscopic procedures are at least 9 months – at The Harley Street Clinic you can receive your procedure in 2-3 weeks.
Mr Toufan Bahrami, Consultant Cardiac Surgeon
Toufan Bahrami has 23 years of experience in minimal access surgery. He’s performed more than 1,500 minimally invasive cardiac procedures, averaging 6-8 per week across men and women in the last year. He is responsible for performing the first private hospital resilia mitral valve replacement through an endoscopic approach at The Harley Street Clinic.
He is passionate about providing a better quality of surgery, performed through sternotomy, using a smaller incision and without opening the breastbone. His passion is endoscopic cardiac surgery, or ‘totally endoscopic’ procedures, which involve a 2.5cm incision (compared to other heart surgeries of up to 20cm) and 3D cameras and screens for enhanced accuracy and better results.
He treats patients at several of our HCA Healthcare UK hospitals including The Wellington Hospital, London Bridge Hospital and The Harley Street Clinic, the latter of which is the only hospital to offer private endoscopic heart surgery.
Q & A
The cardiac surgeon is ultimately responsible for the patients care. The best course of treatment for each patient is decided in the monthly dedicated MDT meeting, consisting of your surgeon, an imaging cardiologist, radiologist, interventional cardiologist, theatre nurse, perfusionist and anaesthetist.
100% of the degenerative mitral valves are repaired
0% conversion to sternotomy
Over 99% well-functioning, competent valves at 10 years post-surgery
4-5 days. Patients are discharged once they’ve been supervised and able to walk, go up and down stairs and shower.
During the procedure you will be put under general anaesthetic. Post-procedure, you will have a ‘local block’ in the form of a catheter linked to the incision which injects pain relief and is removed on day three. Post-discharge there may be some discomfort for a few days, managed by pain medication.
Usually within 3 weeks
4 weeks after surgery you should be fit to fly
At two weeks a patient should be able to do up to 10,000 steps a day. Within four weeks patients have reported being active again and feeling positive, with minimal scarring when compared to a standard procedure.
Post-surgery a patient could be diagnosed with atrial fibrillation, usually treated by medication. Another complication could be plural effusion (small amount of water between the lung and chest wall) which is usually treated with diuretics (urinary tablets).
Due to a smaller incision, there is far less chance of infection compared to surgeries with larger incisions such as a sternotomy, as well as no risk of a sternal disjunction. With the surgery live on-screen for theatre staff to observe, any issues during surgery can be picked up and acted on a lot faster.
Tricuspid and ablation for atrial fibrillation can be performed at the same time as endoscopic mitral valve surgery. In fact, 40% of our patients have multiple valve procedures at the same time.
- Mitral valve surgery - for repair or replacement
- Aortic valve surgery - for repair or replacement
- Coronary artery
- Atrial fibrillation
View consultant
Mr Toufan Bahrami
Cardiothoracic Surgery
Our Endoscopic cardiac surgery locations
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.