Key Hole Heart Surgery (MICS)- New approach to fix an old problem

Far too less people know about minimally invasive heart operation. This is partly because these procedures are fairly new, so only a few doctors are able to perform them as these operations need specialized skill set and advanced instruments.

The man sitting across from me in my OPD had travelled a long way from his home town. He needed heart valve surgery. He could have had traditional surgery at home, but he wanted to know if we could fix his heart valve without the pain of breaking his breastbone. I told him we could – with key hole or minimally invasive heart valve surgery. And after 4 days in hospital, he was back home happy with a new valve in his heart and was back to work at his office within a week.

Unfortunately, far too less people know about minimally invasive heart operation. This is partly because these procedures are fairly new, so only a few doctors are able to perform them as these operations need specialized skill set and advanced instruments. The patients who undergo these operations recover quicker, with fewer complications and return to normal activities much sooner, in as few as 10- 14 days as compared to 6-8 weeks after the traditional surgery. Patients also benefit from decreased chances of wound related problems, infections and lesser need of blood transfusion.

What surgeries can be done?

In this approach, instead of 8-10 inch incision in the midline and dividing the breastbone, we make 2 inch cut between the ribs on one side of the chest and reach the heart . The surgeries which can be performed include:

- All the single valve repairs /replacements - mitral, aortic, tricuspid

- Closure of hole inside the heart- ASD and VSD closure

- Bypass blocks in one or 2 of the 3 arteries of heart (MIDCAB)

Who is a candidate for key hole heart surgery?

The surgical team carefully compares the advantages and disadvantages of minimally invasive techniques with those of traditional surgical methods. The surgeon then decides the best approach for you based on several factors, including the type of heart disease, its severity, your age, medical history and lifestyle; and results of tests done before surgery.

Care after surgery -

Secondary prevention plays a key role in preventing future adverse cardiac events after successful surgery. Apart from regular medications which include blood thinners, statins to reduce cholesterol, diuretics, other measures can be summarized as simple 7 steps.

The Life’s simple 7

1. STOP smoking

2. GET active

3. EAT healthy

4. LOOSE weight

5. REDUCE blood sugar

6. MANAGE your blood pressure

7. CONTROL cholesterol

Cardiac rehabilitation along with regular follow up after surgery holds an equally important role in preventing further heart related problems.

Key hole cardiac surgery continues to evolve and expand with growths in technology and surgeon experience. With enormous research on the safety and efficacy of MICS across a range of surgical operations, there is evidence to support the widespread adaptation of such techniques. Perhaps its time the surgeons and the patients consider the notion that “ LESS is MORE “ exists an option in the cardiac surgery.