Bouncing Back After Robotic Mitral Valve Repair Surgery


When Jack Schrass needed heart surgery, he didn’t have far to go. He drove five minutes to UPMC Passavant–McCandless where a pioneering cardiac surgeon repaired his mitral valve using a minimally invasive robotic-assisted procedure.


It was no surprise when Jack learned that he needed surgery at age 69 to repair a leaky heart valve. Diagnosed in 2001 with mitral valve prolapse, he began seeing UPMC cardiologist Bradley Heppner, MD, 10 years ago for yearly checkups and electrocardiograms.


The heart’s mitral valve is located between the left ventricle and the left atrium, or the upper and lower chambers of the heart. It operates like a one-way gate to stop blood from flowing the wrong way. With mitral valve prolapse, the valve doesn’t close right. That can cause blood to leak back into the atrium—a condition called mitral valve regurgitation. In severe cases, it can lead to congestive heart failure.


By 2021, an increasing amount of blood was leaking back into Jack’s left atrium.


“I had no symptoms, but I had significant backflow of blood,” says Jack, a Ross Township resident. “My heart wasn’t working as efficiently as it could.”


A PIONEERING SURGEON


Jack’s cardiologist referred him to Johannes Bonatti, MD, a cardiac surgeon and director of cardiac robotic surgery at UPMC Heart and Vascular Institute. Before going to his first appointment, Jack did some research—and was impressed.


“I found out that Dr. Bonatti is a pretty big deal,” he says. “I was happy to have a doctor with his credentials and background doing my surgery.”


Dr. Bonatti, who joined UPMC in May 2021, is an internationally recognized expert and pioneer in the use of robotic-assisted cardiothoracic surgery. He has performed more than 5,000 cardiac surgeries, including the world’s first robotic endoscopic quadruple coronary bypass procedure. He performs robotic surgery at UPMC Presbyterian and UPMC Passavant–McCandless.


Jack remembers when his father had open heart surgery and the long, painful recovery he endured. When the retired systems engineer met with Dr. Bonatti, he was delighted to learn his leaky valve could be fixed without opening his chest—and with the help of a robot.


“I was happy to have him do it robotically. I have a high comfort level with technology and I think robotics is the way of the future,” says Jack.


A SPECIALIZED HEART PROCEDURE


During traditional open heart surgery, surgeons cut open the chest and breastbone to access the heart and make repairs. At UPMC, cardiac surgeons prefer to use minimally invasive approaches when possible because patients generally have a reduced risk of infection, spend fewer days in the hospital, and have an overall faster recovery.


The robotic system is an advanced approach to minimally invasive mitral valve repair. It is a cutting-edge surgical tool that provides greater accuracy and visualization of the heart.


“Mitral valve repair is very delicate work,” says Dr. Bonatti. “Robotic surgery allows us to do these procedures without opening the chest. I can use mini-incisions with a precision that is impossible without the robot.”


A PRECISE APPROACH


Unlike open heart surgery, the robotic procedure is performed with several very small incisions on the side of the chest. Another small incision in the groin is used to connect the patient to a heart-lung machine, which keeps blood flowing while the heart is stopped during surgery.


A tiny camera and specially designed surgical instruments are inserted through the ports and a mini-thoracotomy (an incision between the ribs) in the chest. They are attached to robotic arms controlled by the surgeon from a nearby console. The camera enables the surgeon to see inside the chest and heart with a 3D, high-definition view that can be magnified up to 10 times.


“The robot provides better vision and dexterity. You can work in very small spaces inside the body, move and turn around, and do difficult surgical maneuvers,” says Dr. Bonatti.


SURGERY CLOSE TO HOME


Before having surgery, Jack had blood tests and a heart catheterization procedure done at UPMC Passavant–McCandless. He returned to the hospital for surgery on Sept. 21.


“UPMC Passavant has developed into a full-service hospital. I was very happy I could have the surgery done there—and by a pioneering doctor,” says Jack.


“Being able to go to UPMC Passavant just minutes from home was convenient for me and my wife,” he adds. “She stayed with me at the hospital into the evening a couple times. I know she was a lot more comfortable having just a short drive home.”


The day after his operation, Jack was up walking around the intensive care unit. He went home just three days after surgery.


“I was amazed at how well it turned out,” says Jack. “I really didn’t have any pain. I felt very good emotionally and physically.”


ON THE MOVE AGAIN


An energetic grandfather of eight, Jack plays tennis year-round, bikes regularly, and enjoys yardwork. He was eager to return to his active lifestyle, but gladly went through three weeks of cardiac rehab at UPMC Passavant–Cranberry to make sure he was ready.


“I was very pleased with the care provided,” says Jack. “I wore a monitor that kept track of my heartbeat while working on the exercise bike or treadmill. It was reassuring when they told me, ‘Your heartbeat looks good.’”


Jack, now 70, was back to doing yardwork in October and playing tennis again in November. “I’m doing all the things I was doing before. I’m really happy with the way everything turned out,” he says.


“Dr. Bonatti clearly is a very skilled surgeon. All the incisions healed so quicky and cleanly. We’re lucky to have him here at UPMC Passavant.”


Benefits of Robotic-Assisted Surgery

  • Smaller incisions with minimal scarring

  • Less trauma to the patient

  • Shorter hospital stay

  • A faster recovery (three to four weeks compared to 10 to 12 weeks for open heart surgery)

  • Faster return to normal activities


Robotic-Assisted Heart Procedures at UPMC Passavant

  • Coronary artery single and double bypass

  • Mitral valve repair

  • Removal of cardiac tumors

  • Repair holes in the heart


Providing World-Class Cardiac Care in the Northern Suburbs


Robotic-assisted cardiac surgery is just the latest example of the expanded heart and vascular care and advanced technology now available at UPMC Passavant—making it convenient for patients living in Pittsburgh’s northern suburbs and beyond.


Over the past 20 years, UPMC Passavant has grown from providing essential cardiac care to a regional center for advanced heart care and services. A multidisciplinary team of experts use the latest technology, cutting-edge research, and clinical trials to give patients access to the best possible treatment.


Another newer heart and vascular initiative is the Magee-Womens Heart Program—a dedicated cardiology program for women at UPMC Passavant–Cranberry. UPMC Passavant also features the resources of the UPMC Center for Inherited Heart Disease, which focuses on heart rhythm disorders, and the Cardio-Oncology Program with UPMC Hillman Cancer Center, providing care for patients who develop heart conditions related to their cancer diagnosis.


The UPMC Heart and Vascular Institute at UPMC Passavant provides comprehensive care and treatment for every type of heart and vascular condition, including:

  • Advanced heart failure

  • Aortic valve disease

  • Arrhythmias

  • Atrial fibrillation

  • Cardio-oncology

  • Hypertrophic cardiomyopathy

  • Mitral valve stenosis

  • Mitral valve disease

  • Thoracic outlet syndrome

Additional services include:

  • Open heart surgery

  • Transcatheter Aortic

  • Valve Replacement

  • WATCHMAN™ implants for atrial fibrillation

You can find a cardiologist, surgeon, or provider close to where you live or work at UPMCPassavant.com/HVI.


Did You Know?


In January, experts from the UPMC Heart and Vascular Institute began

seeing patients at the new UPMC Primary and Specialty Care in Sewickley. They also recently began seeing patients at the UPMC Outpatient Center in Coraopolis.


UPMC is proud to bring world-class cardiovascular care closer to home for residents throughout Beaver, Butler, and northern Allegheny counties.

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