Categories: Cardiac Surgery

Minimally Invasive Heart Surgery or Key Hole Heart Surgery

Introduction

Minimally invasive heart surgery (MICS) or commonly known as Keyhole heart surgery is the latest and most advanced form of cardiac surgery. It is performed by making small incisions in the left or right side of the chest.  The heart is approached via the natural space between the ribs, rather than cutting through the breastbone, in the front of the chest as is done in an otherwise conventional way. with this technique size of the incision (cut) can be reduced to 5-6 cm as compared to 18-20 cm of the conventional way of open-heart surgery.

Operations done by MICS

Minimally invasive heart surgery can be done to treat many types of heart problems for whom open-heart surgery has been advised, including:

  • Mitral valve replacement or repair
  • Aortic valve replacement
  • Coronary artery bypass surgery
  • Tricuspid valve repair or replacement
  • Atrial septal defect (ASD) closure
  • Double valve replacement

Potential benefits

Minimally invasive heart surgery has become a new evolving subspecialty in cardiac surgery having a wide spectrum of operations. it can be performed safely from the pediatric age group to the elderly.

Having said that, MICS is not an option for everyone. But for those who can undergo surgery, the potential benefits when compared with open-heart surgery can include:

  • Faster recovery
  • Smaller, less noticeable, cosmetically better scars
  • Reduced trauma and pain
  • Less blood loss
  • Shorter time in the hospital
  • Early return to normal activities
  • Lower risk of infection

The heart team which includes a surgeon & a cardiologist together will assess and decide whether it’s an option to operate a condition with a small incision.

Risks

Minimally invasive heart surgery can involve risks similar to open-heart surgery, such as:

  • Bleeding
  • Stroke
  • Infection
  • Irregular heart rhythms (arrhythmias)
  • Death

Also, it’s possible that if it feels unsafe to continue with minimally invasive technique surgery can be converted to open-heart surgery.

Types of Minimally Invasive Heart Surgery

Minimally invasive heart surgery includes surgery through a small incision in the chest (direct vision mini-incision heart surgery), thoracoscopic surgery or robot-assisted heart surgery. In all types of minimally invasive operations, surgeons reach the heart through small incisions between the ribs of the chest. A small video camera inserted through one of the port will enable the surgeon to see inside.

After surgery

After minimally invasive heart surgery, the patient might have an improved quality of life and reduced symptoms. Instructions will be given about when one can return to daily activities, such as household work, driving and exercise and back to job. that can be achieved as short as 2-3 weeks as compared to 6-8 weeks in open-heart surgery. Patients need to attend regular follow-up with the doctor. Few tests will be required to evaluate and monitor the condition of the heart.

Patients need to incorporate healthy lifestyle changes such as physical activity, a healthy diet, stress management and avoiding tobacco use into their life. It might also be recommended that they participate in cardiac rehabilitation — a program of education and exercise designed to help to improve health and to recover after heart surgery.

Dr. Nitin Kumar Rajput | Senior Consultant – Cardiac Surgery – Adult | Narayana Superspeciality Hospital, Gurugram

Narayana Health

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