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Gina Naiser

Each year, thousands of people have surgeries to repair or replace a heart valve. In the past, the only surgical option has been what’s called an “open” surgery, requiring a long incision through the sternum and six to eight weeks of recovery. Today, however, many of these surgeries can be done through a much smaller incision, resulting in a faster recovery and several other benefits.

Get Healthy’s Jackie Hays describes a new procedure available at Norton Audubon Hospital and Norton Hospital downtown.

Patients who have this procedure also will have a small incision in the groin to allow staff to connect them to a heart bypass machine while the surgery is performed. Other benefits of the less invasive surgery include: reduced risk of infection, shorter hospital stay, reduced pain and less blood loss.

To refer a patient to Dr. Etoch, call Cardiothoracic Surgery of Louisville at (502) 636-8004.


Even at 80 years old, Gina Naiser is the picture of good health. This mother of four enjoys working in her yard, baking and cross-stitching. But looks can be deceiving. Gina was born with a leaky heart valve, a condition that seems to run in her family. Twosisters and her son Jeff also have heart valve conditions. The first sign of trouble for Gina was when she passed out about a year ago.

“I fainted and everybody insisted that I go to the doctor,” Gina said. “The doctor sent me for a stress test and said I had a leaky valve.” Her mitral valve, one of four valves that regulate blood flow in the heart, was not opening and closing normally, allowing blood to flow backward and causing the heart to work less efficiently.

Gina was naturally apprehensive about having open heart surgery but was relieved to find out she was a candidate for a new procedure that meant less time in the hospital and a shorter recovery. It’s called minimally invasive cardiac surgery, or MICS.

According to Gina’s surgeon, Steven Etoch, M.D., for the past 30 years the standard incision for heart valve replacement or repair surgery was from the bottom of the throat through the sternum, about 20 centimeters in length. The new MICS procedure requires a much smaller incision of only 5 to 7 centimeters between two ribs.

“The big trend over the last couple years is for a smaller incision and less trauma,” Dr. Etoch said. “The instruments we work with are longer so you can work through a small incision and use your fingers to manipulate the needle at the end.”

For patients, a smaller incision means a faster recovery, less blood loss and more benefits.

“A major advantage is the cosmetic aspect,” Dr. Etoch said. “A traditional incision is obvious to anyone who sees you wearing an open collar. Another advantage is healing time. Since the incision is through the chest wall, we’re not dividing bones. There’s no downtime for bones to heal.”

Patients typically are back to work or activities in four weeks compared to six to eight weeks with a traditional procedure. Other advantages may include less pain, reduced blood loss, reduced risk of infection and a quicker return to daily activities. Although the MICS procedure has many advantages, it’s not for everyone.

Dr. Etoch says MICS works well for patients who have only one valve that needs replacement or repair. When the heart repair is more complicated, surgeons must resort to the traditional open heart procedure. Gina’s son Jeff was fortunate to only have one irregular valve, which he also had since birth. He had MICS to repair his mitral valve shortly after his mother’s procedure.

“When I first learned I had a heart condition, the cardiologist said I’d eventually need heart surgery,” Jeff said. “It sounded scary, and I didn’t like thinking about it.”
Thankful he didn’t need surgery before MICS was available, Jeff now is able to enjoy a longer, healthier life. “I feel fortunate I was able to have this procedure rather than open heart surgery,” he said. “Dr. Etoch did a great job, but I’m glad it’s over.”

Gina also feels fortunate to be healthy, back home and back to her projects. “I know people who’ve had the surgery the old way and it took them a long time to recover and they had a big scar,” Gina said. “I’m glad I got it done. I feel super, like I can do anything.”

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