Step-by-Step Guide: How Minimally Invasive Cardiac Surgery is Performed

What is Minimally Invasive Cardiac Surgery?

Facing heart surgery is scary, but minimally invasive cardiac surgery offers new hope. This advanced technique is designed to treat heart conditions with less trauma to the body than traditional open-heart surgery. Minimally invasive cardiac surgery uses tiny incisions instead of large incisions, making the process less painful and faster recovery. Imagine getting back to your life sooner, with less scarring and discomfort. If you or someone you care about needs heart surgery, this gentle, effective approach can make the journey effortless and the future brighter. Your heart deserves the best care, and so do you.

What are the Advantages of Minimally Invasive Cardiac Surgery?

Minimally invasive cardiac surgery offers a range of benefits that make it an attractive option for many patients. Some of the key advantages of this approach include:

• Reduced Trauma: With smaller incisions, minimally invasive cardiac surgery causes significantly less trauma to the body compared to large incisions through the breastbone (sternotomy) in traditional open-heart surgery. This leads to fast recovery and reduced post-operative pain for the patient.
• Shorter Hospital Stay: Patients undergoing minimally invasive cardiac surgery experience a shorter hospital stay, often just a few days, than the longer recovery period associated with open-heart surgery.
• Lower Risk of Infection: Smaller incisions reduce the risk of infections and other complications.
• Quicker Return to Routine: Due to the reduced trauma and faster recovery, patients can often return to their normal daily activities, such as work and exercise, much sooner after minimally invasive cardiac surgery.
• Improved Cosmetics: The smaller incisions used in minimally invasive cardiac surgery result in less visible scarring, which can be particularly vital for patients concerned about their chest’s aesthetic appearance.
• Reduced Risk of Complications: Minimally invasive cardiac surgery has been shown to have a lower risk of certain complications, like infection and bleeding, compared to traditional open-heart surgery.
• Potential for Improved Outcomes: In some cases, minimally invasive cardiac surgery may lead to better long-term patient outcomes, such as improved heart function and reduced risk of future complications.

How is Minimally Invasive Cardiac Surgery Done?

Minimally invasive cardiac surgery is a complex and precise procedure that requires specialised training and expertise from the surgical team. The process typically involves the following steps:

• Preoperative Evaluation: The patient will undergo a comprehensive medical and physical evaluation to assess overall health and identify any conditions that might affect surgery or recovery. The doctor will perform various diagnostic tests and imaging studies to evaluate the specific heart condition and determine the most appropriate surgical approach, including:
  • Blood Analysis: To check clotting factors, anaemia, and other conditions
  • X-rays: To evaluate heart size and lung condition
  • Electrocardiogram (ECG): To assess heart rhythm and identify any irregularities
  • Echocardiogram: To see various heart structures, such as heart valves, muscles, walls, and blood flow
  • Coronary Angiography: To detect obstruction in coronary arteries
  • Imaging Tests: CT scan and MRI provide detailed images of the heart and surrounding structures
• During the Procedure
  • Anaesthesia and Monitoring: The patient will receive general anaesthesia, and the medical team will closely monitor their vital signs and heart function throughout the procedure.
  • Incision and Access: Instead of a large incision in the chest, the surgeon will make one or more small incisions, typically just a few inches long, to access the heart.
  • Procedure Implementation: The surgeon will then perform the necessary cardiac procedure, such as valve repair or replacement, coronary artery bypass, or atrial fibrillation ablation, using the minimally invasive approach.
  • Closure and Wound Care: Once the surgery is over, the incisions will be closed using sutures or staples, and the patient will receive appropriate wound care to promote healing.

Preparing for Minimally Invasive Heart Surgery

Preparing for minimally invasive cardiac surgery involves a comprehensive and collaborative approach between the patient, their medical team, and their support network. The preparation phase includes the following steps:

• Medical Evaluation: Patients will undergo a detailed medical examination, a review of their medical history, physical examination, and diagnostic tests to ensure they are suitable candidates for minimally invasive cardiac surgery.
• Patient Education: The medical team will provide detailed information about the surgical procedure, including the expected benefits, risks, and recovery process, to ensure that the patient fully understands the procedure and makes an informed decision.
• Lifestyle Modifications: Doctors may advise patients to make certain lifestyle adjustments, such as quitting smoking, losing weight, or improving their overall cardiovascular health, to optimise their chances of a successful outcome.
• Medication Management: In preparation for the surgery, patients may need to temporarily discontinue certain medicines, such as blood thinners or anti-inflammatory drugs.
• Preoperative Tests and Imaging: Additional diagnostic tests, such as blood work, electrocardiograms, and imaging studies, may be performed to analyse the patient’s condition further and guide the surgical plan.
• Support System Mobilisation: Patients are encouraged to enlist the support of family members, friends, or a caregiver who can assist with the recovery process and provide emotional support during the pre- and post-operative phases.

The Surgical Techniques Used in Minimally Invasive Cardiac Surgery

Minimally invasive cardiac surgery encompasses a range of surgical techniques that aim to minimise the procedure’s invasiveness. Some of the most common methods used in this approach include:

• Robotic-Assisted Cardiac Surgery: The surgeon uses a sophisticated robotic system to perform the surgical procedure through small incisions with enhanced precision and skill.
• Thoracoscopic Cardiac Surgery: This technique involves the use of small video cameras and surgical instruments. These are inserted through small incisions in the chest wall to access and operate on the heart.
• Minimally Invasive Direct Coronary Artery Bypass (MIDCAB): Here, the surgeon creates a small incision in the chest to access and bypass blocked coronary arteries without the need for a full sternotomy.
• Transcatheter Valve Procedures: These minimally invasive techniques, like Transcatheter Aortic Valve Replacement (also called TAVR) and Transcatheter Mitral Valve Repair ( also called TMVR), allow for the replacement or repair of heart valves without the requirement for open-heart surgery.
• Hybrid Procedures: In some cases, surgeons may combine minimally invasive and traditional surgical procedures to address complex heart conditions, leveraging the benefits of both approaches.

What are the Risks of Minimally Invasive Cardiac Surgery?

While minimally invasive cardiac surgery is generally considered a safe and effective approach, there are still some risks and complications that one should be aware of, including:

• Bleeding: As with other surgical procedures, there is a risk of bleeding, which may need additional treatment or blood transfusion.
• Infection: Although the chance of infection is lower compared to traditional open-heart surgery, there is still a possibility of a wound or internal infection that may require antibiotic treatment.
• Stroke: In rare cases, minimally invasive cardiac surgery may increase the risk of stroke, particularly in patients with pre-existing vascular conditions.
• Arrhythmias: Following the surgery, patients may experience temporary or persistent heart rhythm disturbances, such as atrial fibrillation.
• Conversion to Open-Heart Surgery: In some cases, the surgeon converts the minimally invasive approach to a traditional open-heart surgery if the surgeon encounters unexpected complications or technical challenges during the procedure.
• Organ Damage: While rare, there is a small risk of damage to other organs, such as the lungs, during the minimally invasive procedure.

What to expect after minimally invasive heart surgery?

After undergoing minimally invasive cardiac surgery, patients can expect a relatively shorter and more comfortable recovery process compared to traditional open-heart surgery. The post-operative care and recovery plan typically includes the following elements:

• Hospital Stay: Patients undergoing minimally invasive cardiac surgery have a shorter hospital stay, usually 2 to 5 days. The stay depends on the procedure and the patient’s recovery progress.
• Pain Management: The medical team will provide patients with pain medication to manage pain and discomfort during the initial recovery period. The use of pain medication is typically reduced more quickly compared to traditional open-heart surgery.
• Wound Care: The smaller incisions used in minimally invasive cardiac surgery require less extensive wound care, with patients often able to resume light activities and self-care tasks more quickly.
• Cardiac Rehabilitation: Patients will be encouraged to participate in a cardiac rehabilitation program, including exercise, education, and counselling, to help them regain their strength, improve their cardiovascular health, and transition back to their normal daily activities.
• Follow-up Care: Patients will be called for regular follow-up visits so that their medical team can monitor their progress, address concerns, and ensure a smooth and successful recovery.
• Lifestyle Modifications: Doctors may advise patients to make certain lifestyle changes to support their long-term cardiovascular health. These changes include maintaining a healthy meal, exercising regularly, and managing underlying health conditions.

Conclusion

Minimally invasive cardiac surgery has emerged as a transformative approach to heart surgery, offering numerous benefits for patients compared to traditional open-heart procedures, says Dr. Ashwini Kumar Pasarad. From less trauma and faster recovery times to improved cosmetic outcomes and the potential for better long-term results, this innovative technique has become an increasingly attractive option for many individuals facing heart conditions that require surgical intervention.