Minimally invasive heart surgery involves making small incisions in the right side of your chest to reach the heart between the ribs, rather than cutting through the breastbone, as is done in open-heart surgery.
Minimally invasive heart surgery can be performed to treat a variety of heart conditions. Compared with open-heart surgery, this type of surgery might mean less pain and a quicker recovery for many people.
In minimally invasive heart surgery, surgeons make small incisions in the side of your chest, between your ribs, to reach your heart. Surgeons conduct the procedure using long instruments.
Many types of heart procedures may be conducted with minimally invasive heart surgery, including:
Minimally invasive heart surgery isn't an option for everyone. But for those who can have the surgery, the potential benefits when compared with open-heart surgery can include:
Not everyone is a candidate for minimally invasive heart surgery. Your doctor and treatment team will work with you to determine whether it's an option to treat your condition.
To determine whether you're a candidate for minimally invasive heart surgery, your doctor is likely to conduct a physical examination, review your medical history and perform tests.
Minimally invasive heart surgery is a complex surgical procedure that requires training and experience. You might be referred to a medical center with surgeons and a surgical team who have the needed expertise in conducting minimally invasive procedures.
Minimally invasive heart surgery can involve risks similar to open-heart surgery, such as:
Also, it's possible that minimally invasive heart surgery will need to be changed to open-heart surgery if your surgeon thinks it's not safe to continue with the minimal approach.
Before minimally invasive heart surgery, your doctor and treatment team will explain to you what to expect before, during and after the surgery and potential risks of the surgery.
Your doctor and team will discuss concerns you have about your surgery. Your doctor or another member of your treatment team might discuss with you advance directives or other information to consider prior to your surgery.
You may need to have your hair shaved at the areas of your body where the procedure will take place. Your skin might be washed with special soap to reduce the risk of infection.
Before being admitted to the hospital for your surgery, talk to your family about your hospital stay and discuss help you might need when you return home. Your doctor and treatment team will give you instructions to follow during your recovery when you return home.
Talk to your doctor about:
Your treatment team might recommend bringing several items to the hospital, including:
During surgery, avoid wearing:
Talk to your doctor about:
Minimally invasive heart surgery includes robot-assisted heart surgery, thoracoscopic surgery and surgery through a small incision in the chest (direct less invasive access heart surgery). In all types of minimally invasive procedures, surgeons reach your heart through small incisions between the ribs of your chest.
A tool with a small video camera inserted through one of the incisions will enable the surgeon to see inside your body.
Most minimally invasive procedures use a heart-lung bypass machine, as is used in open-heart surgery. The machine keeps blood moving through your body during the procedure.
In robot-assisted heart surgery, the surgeon uses robotic arms, rather than his or her hands, to perform the exact maneuvers used in traditional open-heart surgery.
During this procedure, your surgeon works at a remote console and views your heart in a magnified high-definition 3D view on a video monitor. From the console, your surgeon's hand movements translate precisely to the robotic arms at the operating table, which move similarly to the human wrist.
A second surgeon and surgical team assist at the operating table, changing surgical instruments attached to the robotic arms.
In thoracoscopic surgery (sometimes referred to as a minithoracotomy), your surgeon inserts a long, thin tube (thoracoscope) containing a tiny high-definition video camera into a small incision in your chest.
Your surgeon repairs your heart using long instruments inserted through small incisions between your ribs.
You'll generally spend a day or so in the intensive care unit (ICU). You'll be given fluids and medications through intravenous (IV) lines. Other tubes placed during surgery will drain urine from your bladder and fluid and blood from your chest. You might be given oxygen through a facemask or prongs in your nose.
After the ICU, you'll be moved to a regular hospital room for several days. The time you spend in the ICU and hospital will depend on your condition and surgery.
Your treatment team will:
Your doctor will give you instructions to follow during your recovery, such as watching for signs of infection in your incisions, caring for your incisions, taking medications and managing pain.
In robot-assisted heart surgery, surgeons create small incisions between the ribs of your chest. Robotic arms with small instruments and a camera are inserted through the incision sites.
In robot-assisted heart surgery, a surgeon sits at a remote console and views the heart on a video monitor. The surgeon uses robotic arms to conduct the procedure. A surgical team assists at the operating table.
During robot-assisted heart surgery, a doctor works at a remote console controlling the robotic instruments, which use small, precise movements to perform the surgery.
After minimally invasive heart surgery, you might have an improved quality of life and reduced symptoms.
Your doctor will instruct you about when you can return to daily activities, such as working, driving and exercise.
You'll need to attend regular follow-up appointments with your doctor. You might have several tests to evaluate and monitor your condition.
Your doctor might instruct you to incorporate healthy lifestyle changes — such as physical activity, a healthy diet, stress management and avoiding tobacco use — into your life.
Your doctor might also recommend that you participate in cardiac rehabilitation — a program of education and exercise designed to help you improve your health and help you recover after heart surgery.