Everything about Minimally Invasive Heart Surgery

It's normal to feel a little scared when your doctor tells you that you need heart surgery. Many people think of it as a very painful procedure that involves making a large incision in the middle of the chest and staying in the hospital for a long time. But today, medical science has advanced a lot. There are methods that treat the heart through a few small holes instead of making large incisions like before. That method is what we call Minimally Invasive Heart Surgery . Today, we will talk about this simply, in a way that you can understand.

Simply put, what is Minimally Invasive Heart Surgery?

Imagine, in traditional open-heart surgery, the surgeon cuts the entire breastbone (sternum) in the middle of your chest to reach your heart. This takes a long time to heal, is very painful, and leaves a large scar.

But in this new method, called Minimally Invasive Surgery, there's no such large incision. Instead, one or more very small incisions are made on the side of your chest, between your ribs. Then, high-tech cameras, very delicate surgical instruments, and sometimes robotic arms are inserted through these small incisions to perform the necessary surgery on your heart.

Let's look at the table below to further clarify the difference between these two methods.

What types of surgeries are these?

There are two main types of minimally invasive heart surgery.

1. Thoracoscopic surgery: In this, the surgeon inserts a long tube with a camera called a thoracoscope through a small hole in the side of the chest. The surgeon uses long, thin instruments inserted through other holes to perform the surgery, using images from this camera.

2. Robotically assisted heart surgery: This is the most advanced of these methods. Here too, small holes are made in the side of the chest. However, the surgery is not performed directly by the doctor. He sits in front of a computer control system (console) and controls the robotic arms. These robotic arms can work more delicately, accurately, and without moving than a human arm. Also, since three-dimensional (3D) images are obtained, the surgery can be performed while looking at a very clear image of the heart.

What types of heart diseases is this method used for?

Not all heart surgeries can be performed using this method. However, many common surgeries are now successfully performed using this method. Your doctor will decide whether this method is right for you.

• Valve repairs or replacements, especially surgeries involving the mitral valve.
• Conditions such as atrial septal defect (ASD) , which causes holes in the heart to close.
• Cardiac tumor removal.
• Some coronary artery bypass surgeries .
• Treatments such as the Maze procedure for heart rhythm irregularities (arrhythmias).
• Installation of a ventricular assist device.

What happens before and after the surgery?

Before surgery

Your surgeon will give you instructions on how to prepare for the surgery. You may be asked to stop taking certain medications (especially blood thinners) a few days before the surgery. You will be given general anesthesia so that you will not feel anything during the surgery.

You will be connected to a heart-lung machine to maintain blood circulation in your body during the surgery.

During surgery

As mentioned earlier, the surgeon makes one or more small incisions in the side of the chest. Through these, a camera and instruments are inserted to perform the necessary heart repair, valve replacement, or other treatment. When the work is complete, the small holes are stitched shut. This entire procedure can usually take anywhere from two to six hours .

After the surgery

After surgery, you will be monitored in the intensive care unit (ICU) for a day or two. You may have several small drainage tubes placed outside your chest to stop fluid from building up around your heart.

Then you will be transferred to a regular ward. Surprisingly, you will be helped to get up and walk within a day or two after the surgery. You will also be taught breathing exercises to prevent mucus from building up in your lungs. You will usually be able to go home in a few days.

What are the risks of this surgery?

As with any surgery, there are some risks involved, but compared to open surgery, the risk of complications is much lower.

Possible risks:

• Bleeding
• Infections
• Heart rhythm irregularities (arrhythmias)
• Stroke

Very rarely, if during the procedure the surgeon feels that the minimally invasive method is no longer safe, they may switch to open surgery immediately. This happens very rarely, but it is important to be aware of it.

How long does it take to heal?

This is the biggest advantage of this method. After open surgery, you cannot do heavy work or drive for several months. However, after Minimally Invasive surgery, you can return to your normal activities in as little as two to four weeks .

You may feel a little more tired than usual for the first few weeks. This is normal. It is best not to do anything heavy, such as lifting weights, for a few weeks. Your doctor will tell you how to gradually increase your activity level as appropriate. You may also be referred to a cardiac rehabilitation program . This will help you learn how to exercise safely and eat a heart-healthy diet.

What are the signs that you should see a doctor after surgery?

If you experience any of the symptoms below after returning home, you should call your doctor immediately .

• Pus or fluid draining from cuts.
• Excessive swelling or redness around the wound.
• Fever or feeling cold.
• Feeling of abnormal heart rate (heart palpitations).
• Abnormal swelling of the legs or feet (edema).
• Weight gain of more than 1.5 kg (3 pounds) within a week.

These could be signs of an infection or other complication, so don't ignore them.