For years, Nanette Contat's heart has been enlarged, and the 64-year-old Perrysburg resident has put off having surgery for a faulty mitral valve.

But Mrs. Contat had the valve repaired last week by Toledo cardiac surgeon Dr. Michael Moront, who used minimally invasive surgery featuring a small incision on the right side of her chest. Normally, such surgery would require making a large incision down her chest's center, not to mention cracking her breastbone instead of spreading her ribs, said Dr. Moront of Cardiothoracic Surgeons for Northwest Ohio.

"You can recover more quickly, at least that's what I'm praying," Mrs. Contat said. "He said I'll have a 90 percent chance, and I'll take that chance."

An early adopter of minimally invasive cardiac surgery, Dr. Moront is helping spread the use of such techniques. He is the only Toledo-area surgeon and one of few nationwide who teaches minimally invasive cardiac surgery training courses for Medtronic Inc., a medical device and equipment company.

Although patients are able to leave the hospital sooner and return to their normal activities earlier with minimally invasive surgery, using the techniques is more complicated for surgeons, Dr. Moront said.

He has trained doctors and surgical teams in Germany, England, and throughout the United States, some of whom come to Toledo Hospital for sessions.

"I won't lie to you: The learning curve is very steep," said Dr. Moront, who started doing minimally invasive cardiac surgery three years ago.

"You don't have the control you do with an open sternum, and that's how surgeons have been taught," he added, referring to the traditional method of cracking the breastbone. "We're used to having access to an open heart."

Medtronic and other medical companies long have used doctors nationwide to teach their peers how to use devices and equipment they make.

Toledo is one of 10 or so cities nationwide where at least some minimally invasive cardiac surgery techniques are taught through Medtronic's training program.

Until this year, Dr. Moront was the only surgeon nationwide working with Medtronic who taught others how to use a stentless replacement for an aortic valve, said Daniel Beach, a Medtronic spokesman.

Some patients, such as those with sunken breastbones, are not good candidates for minimally invasive cardiac surgery, Dr. Moront said. It cannot be used for coronary bypass surgery, either, he said.

Last week, Dr. Moront held a two-day training session on different minimally invasive procedures for surgical team members, including nurses from the University of Michigan.

A surgeon and several other personnel, such as a perfusionist to run a heart-lung machine, are needed for the procedures.

"There's a lot of different things going on here," Dr. Moront said. "It's truly a team approach."

Dr. James O'Rourke, chief of cardiac surgery at Lourdes Hospital in Paducah, Ky., was one of the surgeons in Dr. Moront's training session last week.

Dr. Moront had a camera on his forehead while operating so Dr. O'Rourke and the others could watch the procedures on a large screen in the operating room.

It is much better to observe live surgeries and ask questions, as he did with Dr. Moront, than read a journal article or watch a DVD, Dr. O'Rourke said.

Only straightforward cases typically are selected for such instructional materials, but if a difficulty comes up during a training session, the learner can observe how it is handled, he said.

"You don't really get the full impact by reading or looking at pictures," Dr. O'Rourke said. "The best way to learn something is to be right there."

Mrs. Contat, meanwhile, said she readily agreed when Dr. Moront asked whether she would be willing to be one of the patients used for the training session.

"If I can be useful to someone else down the way, why not?" she said.

Contact Julie M. McKinnon at:

jmckinnon@theblade.com

or 419-724-6087.

First Published March 30, 2009, 11:22 a.m.