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Minimally invasive cardiac surgery is a medical procedure used to treat various heart conditions. This particular method can be used in multiple cardiac surgeries and involves making smaller incisions, rather than one large one to access the heart. In this method, the surgeon does not cut through the breastbone to reach the heart and treat the problem, instead uses smaller incisions and several medically advanced equipment.

A minimally invasive cardiac surgery is the ideal choice for many patients; however, the suitability of the procedure to the patient’s condition is determined only after the doctor screen the medical history, conducts a physical exam and runs some tests. Not all patients qualify for the surgery.

Candidates who meet the below criteria are eligible for minimally invasive cardiac surgery:

  • 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

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 

Risks of minimally invasive cardiac surgery

Even though this surgical method is highly safe and effective, as compared to the open-heart surgery, it still has some risks associated with it. Some of the common ones include:

  • Bleeding
  • Stroke
  • Infection
  • Irregular heartbeat, also called (arrhythmias)
  • Death (very rare)

In some cases, the doctor might convert the procedure from a minimally invasive method to open-heart surgery, in case the doctor feels the patient is safer in the latter.

The procedure of a minimally invasive cardiac surgery

To prepare for the minimally invasive cardiac surgery, the patient will be advised to not eat or drink anything before certain hours from the surgery. Moreover, specific medications will be discontinued to reduce the chances of post-operative risks. The patient will need to disclose all allergies and reactions if any before the procedure.

During the procedure, the surgeon access the heart through small incisions made between the ribs of the chest, instead of the breastbone like that of open-heart surgery. Then a tool (usually a catheter) mounted with a small video camera is inserted through one of the incisions to reach the affected area via guided images from the X-ray. This allows the surgeon to see inside the body and then treat the condition accordingly.

Once the tool is in place, the surgeon passes the required advanced medical instrument through the tool to treat the concerned condition.

Typically, minimally invasive cardiac surgery can be performed by the following methods:

  • Robot-assisted heart surgery: In this method, the surgeon uses robotic arms to perform the exact procedure. During the process, the doctor works at a remote console and views the heart via a magnified 3D monitor. From the console, the hand movements translate into the robotic arm action at the operating table to treat the problem.
  • Thoracoscopic surgery: Also known as mini-thoracotomy. In this, the surgeon inserts a flexible, long, thin tube known as a thoracoscope, mounted with a tiny camera into one of the small incisions made in the chest. The surgeon then repairs the heart by using long instruments inserted through the small incisions in the ribs.

After the procedure, the patient is generally kept under observation for a day or two and monitored in the hospital to check for:

  • Any signs of infection in the incision sites
  • Blood pressure, breathing and heart rate
  • Pain and any other postoperative complication

The doctors will also assist the patient in walking and provide instructions on precautions, medications, watching for infections and how to gradually increase activity and resume a normal life.

Results of minimally invasive cardiac surgery

Often, patients who undergo minimally invasive cardiac surgery have a high recovery rate, an improved quality of life and reduced symptoms. The doctor will provide complete guidance on how to resume normal activities, such as driving, exercising, etc.

The patient will need to make follow-up appointments where the doctor might conduct several tests to check and monitor the condition. Moreover, the doctor will advise the patient on how to follow a healthy lifestyle to prevent future complications and ensure a healthy heart. These will include:

  • Physical exercise
  • Active lifestyle
  • Quitting smoking
  • Reducing alcohol intake
  • Stress management
  • Healthy diet

In some cases, the patients are also advised to undergo a cardiac rehabilitation program to allow the body to recover completely and improve heart health.

Overall, minimally invasive cardiac surgery is an ideal choice for patients who have minimum complications and a non-complex underlying issue.

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