Minimally Invasive Heart Surgery

Many heart conditions can be treated without surgery. However, if lifestyle changes, medications or nonsurgical procedures no longer work or if traditional open-heart surgery is too risky, minimally invasive heart surgery may be an option to correct heart-related problems.

Various types of heart surgery can effectively treat a range of heart conditions, such as:

Coronary artery disease
Heart valve disease
Arrhythmia
Heart failure
Heart aneurysm
Angina
Damaged and abnormal heart structures, including congenital heart defects

The type of heart surgery recommended depends on a patient's specific heart condition, overall health and other relevant factors. In some instances, heart surgery may be performed as an emergency response, such as during a severe heart attack. In other cases, patients may be able to plan heart surgery ahead of time.

What Is Minimally Invasive Heart Surgery?

In a minimally invasive heart surgery procedure, also called limited-access coronary artery surgery, surgeons make incisions as small as two to three inches between the ribs and insert tools with a video camera at the tip through the chest to operate on the heart.

Minimally invasive heart surgery may involve a heart-lung bypass machine in some cases. A heart-lung bypass machine takes over the job of the heart and lungs by adding oxygen to the patient's blood through the machine's tubes and pumping it throughout the body while the heart is not beating.

With minimally invasive heart surgery, surgeons can manage blockages in blood flow to the heart to help improve blood and oxygen supply, ease chest pain (angina), reduce the risk of heart attacks and enhance a patient's ability for physical activity.

Some benefits of minimally invasive treatment options may be a lower risk of infection, less trauma to the chest and heart muscle tissue, reduced length of hospital stay and decreased recovery time.

How Is Minimally Invasive Heart Surgery Performed?

The two types of minimally invasive heart surgery are robot-assisted heart surgery and thoracoscopic surgery.

Robot-Assisted Heart Surgery: With this method, surgeons use a computer to control small robotic arms inserted through small incisions to perform heart surgery while watching a high-definition video of the heart and the inside of the patient's chest. Robotic-assisted heart surgery enables surgeons to perform precise and controlled movements during complex operations.

Thoracoscopic Surgery (also called mini-thoracotomy): In this minimally invasive heart surgery procedure, surgeons insert a thoracoscope—a long, thin and flexible tube equipped with a small video camera and small surgical tools through a small incision between the ribs to examine and repair the heart. In some cases, surgeons perform thoracoscopic surgery as part of video-assisted thoracic surgery (VATS). Surgeons commonly perform thoracoscopic surgery to treat heart lesions (such as coronary artery disease and valve problems), lung cancer, chest trauma, esophageal cancer, emphysema and heart and lung transplantation.

Minimally invasive heart surgery can be used in various procedures, including:

Minimally invasive heart bypass surgery or coronary artery bypass graft surgery (CABG): A medical procedure that involves using healthy blood vessels from another part of the body, usually from the arm or chest or veins from the legs and connecting them to blood vessels above and below a blocked artery. This new blood vessel is called a graft. Minimally invasive heart bypass surgery creates a new pathway for oxygen-rich blood to flow around or "bypass" the narrowed or blocked coronary arteries.

Minimally invasive heart valve surgery: Surgeons perform minimally invasive heart valve surgery to repair or replace diseased valves. Surgeons repair the ring-like part around the valve by sewing a ring of plastic, cloth or tissue around it or trimming, shaping or rebuilding one or more leaflets (flaps that open and close the valve). If the valve is too damaged, valve replacement surgery will be necessary. During this procedure, the surgeon will replace the damaged valve with either a mechanical (made from metal or ceramic) or a biological (made from human or animal tissue) valve. The mitral valve is the most commonly replaced, while the aortic valve is usually replaced rather than repaired. The tricuspid and pulmonic valves are rarely repaired or replaced.

Maze procedure: This surgery involves making small incisions in the upper heart stitched together to form scar tissue. This scar tissue disrupts the electrical signals that cause atrial fibrillation, helping to restore a normal heartbeat.

Pacemaker or implantable cardioverter-defibrillator (ICD) insertion: Defibrillators and pacemakers help manage heart rhythms. Defibrillators restore a normal heartbeat by sending an electric pulse or shock to the heart, preventing or correcting arrhythmias and restarting the heart if it stops due to ventricular fibrillation. Pacemakers send electrical pulses to maintain a normal heart rate and rhythm and synchronize heart chambers for efficient blood pumping. Pacemakers can be temporary or permanent, with permanent ones consisting of a small battery implanted under the skin and leads connecting to the heart muscles.

Ventricular-assist device (VAD) placement: A ventricular-assist device is a mechanical pump that aids the heart in pumping blood when it cannot efficiently do so. This device can support the heart's lower chambers, the left, right, or both ventricles. A VAD consists of tubes to transport blood, a power source and a control unit to monitor its function. Ventricular-assist devices can be used to help the heart recover, support the heart while awaiting a heart transplant or improve heart function for patients not eligible for a heart transplant.

Who Is a Candidate for Minimally Invasive Heart Surgery?

Candidates for minimally invasive heart surgery usually include individuals who need specific heart procedures but are at higher risk for complications from traditional open-heart surgery. Many patients qualify for a minimally invasive heart surgery approach. People with severe aortic stenosis or mitral regurgitation are some of those who may benefit from less invasive heart surgery. To determine if you are a suitable candidate for minimally invasive heart surgery, consult a cardiovascular surgeon experienced in these techniques. Together, we can help decide your best possible treatment plan.

How Long Does Minimally Invasive Heart Surgery Take?

Minimally invasive heart surgery, such as coronary artery bypass graft surgery, usually takes three to six hours. However, the procedure may take longer depending on the number of arteries that need to be bypassed.

Find a Cardiovascular and Thoracic Surgeon in San Antonio

Heart care is a journey better taken together. When it comes to your heart health, finding the right partner in care is crucial. The cardiovascular and thoracic team at Cardiovascular and Thoracic Surgical Institute of Texas, a member of Baptist Medical Network in San Antonio, combines experience and compassionate care to help you understand your risk or explore solutions to treat or manage symptoms if you already have a cardiovascular condition.

Whether you need heart surgery, lung procedures or vascular interventions, let us help you navigate your journey to better health. To connect with our patient navigator, call 210-798-4311 or find a cardiovascular and thoracic surgeon here. Please don't delay care.

Takeaways

People respond differently to heart surgery. Recovery time depends on your type of surgery, overall health and specific heart problems. Most heart surgery patients spend a day or more in the intensive care unit, followed by several days in another part of the hospital before going home.

Although heart surgery is often successful, it carries risks, such as bleeding, infection or damage to other organs. Your healthcare team will provide follow-up instructions, medications and guidance on when you should expect to resume daily activities, such as driving and working. Discomfort and some pain after heart surgery are normal.

After heart surgery, regular checkups with your provider or surgeon are essential for monitoring recovery and preventing future heart problems. These visits may include blood tests and heart tests to assess how well your heart is functioning. Additionally, taking prescribed medications, making heart-healthy lifestyle changes and participating in cardiac rehabilitation (if recommended) can help protect your heart and support recovery.