A minimally invasive cardiac surgery is a medical procedure which involves making small incisions on the right side of the chest to access the heart. Unlike, an open-heart surgery, this procedure is minimally invasive and aims to reach the heart without cutting through the breastbone.
Minimally invasive cardiac surgery can be performed to treat a variety of heart conditions. In comparison, to open-heart surgery, a minimally invasive cardiac procedure is safer and also offers a fast recovery rate.
Reason for minimally invasive cardiac surgery
Minimally invasive cardiac surgery can be performed to treat patients with several types of heart conditions. Many procedures can be performed via the minimally invasive technique such as:
- Mitral valve repair or replacement
- Tricuspid valve repair or replacement
- Aortic valve repair or replacement
- Atrial septal defect and patent foramen ovale closure
- Maze procedure
- Atrioventricular septal defect procedure
- Coronary artery bypass surgery
- Saphenous vein harvest
Benefits of a minimally invasive cardiac surgery
Even though a minimally invasive cardiac procedure is highly safe, simple and offers fast recovery rate, yet the surgical method is not the perfect choice for all kinds of patients. However, for patients who qualify for this particular method, the potential benefits when compared to an open-heart surgery include:
- Smaller incisions
- Less blood loss and decreased need for blood transfusion
- Low chances of infection
- Reduced trauma and pain
- Less stress
- Faster recovery with less time in the hospital
- Fewer physical restrictions even in recovery
- Simple procedure
- A smaller, less noticeable scar
- Quicker return to normal activities
- Low risk of complications
That said, it is important to note that these benefits might not accrue to all patients undergoing minimally invasive surgery. The benefits vary per case and are hugely dependent on the severity of the condition and the underlying problem.
Candidates for a minimally invasive cardiac surgery
Not everyone qualifies for minimally invasive cardiac surgery. The doctor will check if this the right treatment option for the patient by conducting a physical examination, extensively reviewing the medical history of the patient, as well as performing several tests to confirm the analysis.
Candidates for minimally invasive cardiac surgery include people who have the following conditions:
- Blocked or narrowed blood vessels on the left side of the heart only
- No record of a previous heart bypass surgery
- No signs of pre-existing scar tissue in the heart or the chest
- No dilated or enlarged blood vessels
Types of minimally invasive cardiac surgeries
Some of the most common procedures which can be performed with the minimally invasive technique include:
Mitral valve repair or replacement: This is a surgical procedure to repair or replace the mitral valve which is not functioning properly due to a valvular heart problem. These valves can either have problems with their closing or could be impacted by narrowing thus inhibiting the blood flow and not opening properly.
Aortic valve replacement: Minimally invasive method can be used to replace the aortic valve with a new valve. This is the standard for treating patients with severe aortic stenosis and offers low mortality rate, low stroke rates and excellent long-term valve durability. Aortic valve replacement can be from a human donor or made from animal tissue. However, it could also be a mechanical valve made of metal, plastic, and/or pyrolytic carbon.
Coronary artery bypass grafting (CABG): Coronary artery bypass grafting (CABG) is aimed to improve poor blood flow to the heart caused by narrowing or blocking of arteries due to build-up of plaque. These arteries called coronary arteries are blood vessels responsible for supplying blood, oxygen and nutrients to the heart tissue. When these arteries are blocked or narrowed due to accumulation of plaque – fatty material within the walls of the arteries – the heart is restricted or limited of supply of oxygen-rich blood, causing severe symptoms including a heart attack in severe cases. This plaque is formed in the arteries when the inner walls of the arteries are damaged or injured due to several factors such as unhealthy diet, smoking, high blood pressure, high cholesterol, diabetes, and a sedentary lifestyle. This plaque – a build-up of fat, cholesterol, calcium, and other substances – tends to stick to the inner walls of the arteries, restricting the blood flow and thereby causing a system malfunction.
Atrial Septal Defect or ASD: This type of heart hole is present in the portion of the septum that separates the right and left chambers of the heart, causing oxygen-rich blood from the left chamber (atrium) to flow into the right chamber rather than flowing into the left ventricle as per normal process. This leads to oxygen-rich blood flowing back into the lungs instead of flowing into the body.
Transcatheter Aortic Valve Replacement (TAVR) or Transcatheter Aortic Valve Implantation (TAVI): TAVR or TAVIis a surgical method performed to repair a compromised, blocked or narrowed artery which was disrupting the blood and oxygen supply to the heart. This surgical procedure is recommended for patients who have a higher risk or are too sick or suffer from severe aortic stenosis, or too old for open-heart surgery. The Transcatheter Aortic Valve Replacement (TAVI/TAVR) procedure involves the implantation of the aortic valve via a catheter without removing the damaged, old valve. Instead, TAVI/TAVR wedges another valve into the aortic valve’s place (valve-within-valve). This breakthrough procedure is advanced than a standard valve replacement. Where a standard valve replacement surgery involves an open heart surgery by a sternotomy via a surgically opened chest, a TAVI/TAVR process is less invasive and involves small openings that do not harm the chest bones.
Left Ventricular Assist Device (LVAD): LVAD is a pump used to help patients who have end-stage heart failure. This battery-operated, mechanical pump can be surgically implanted using the minimally invasive technique to help the left ventricle pump blood to the rest of the body effectively.
Maze procedure for Atrial Fibrillation: Minimally invasive method can be used to treat atrial fibrillation which is the most common type of heart arrhythmia. This condition increases the chances of a stroke, heart failure or other heart-related problems. In the maze procedure, the surgeon makes small incisions in the upper portion of the heart and stitches them together to develop a scar tissue which stops abnormal signals.
Overall, a minimally invasive cardiac surgery is highly effective and has a lot of advantages over traditional open-heart surgeries, provided the patient qualifies as a candidate.