Understanding Minimally Invasive Cardiac Surgery- Dr Zainulabedin Hamdulay
Minimally Invasive Cardiac Surgery
There are many heart conditions in which there is no other alternative left than that of surgery.
Previously, there was no other way, than to go for open heart surgeries for treating such problems. But now, with great advancements in medical science, it is possible to carry out minimally invasive cardiac surgery. In this article, we will discuss this type of surgery in detail.
What is minimally invasive cardiac surgery and when can it be used?
It is evident from the name of the surgery that cardiac surgery is done by making small incisions on the right side of the chest. This is an alternative to open heart surgery. Like open heart surgery, the breastbone does not need to be split up for operating between the ribs. The result is quicker recovery and lesser pain from the surgery.
It has been seen that in minimally invasive cardiac surgery the heart surgeon can get better views of certain parts of the heart when compared to that of open heart surgery. For the surgery, a heart-lung machine is needed as the heart is stopped temporarily and the blood is diverted from the heart with the help of the machine. Some of the conditions in which minimally invasive cardiac surgery can be carried out include the following:
- Aortic valve surgery
- Closure of atrial septal defect
- Heart valve surgery
- Mitral valve surgery
- Atrioventricular septal defect surgery
- Tricuspid valve surgery
- Maze heart surgery for treating atrial fibrillation
- Saphenous vein harvests
In case a patient has had a cardiac surgery previously, minimally invasive surgery cannot be done.
Various kinds of tests and investigations are done on the patient to understand if he is suitable for the surgery or not.
What are the main advantages of minimally invasive cardiac surgery?
More and more numbers of people are looking for minimally invasive cardiac surgery for the various benefits, which are offered. Some of the most important ones among them are:
- Less blood loss during the surgery
- Lower risks of infections as area of incision is small
- Minimal pain and trauma, which is natural after a cardiac surgery
- Less noticeable and smaller scars
- Shorter stay time in the hospital
- Faster recovery when compared to open heart surgery
- Risks of complications are minimal
- Less post-operative discomfort
What are the different kinds of minimally invasive cardiac surgeries that are done?
- Thoracoscopic surgery–The surgery procedure is also known as mini-thoracotomy. In the process, a thorascope is inserted into a small incision in the chest so that the damaged parts in the heart can be repaired. The thorscope contains a small high-definition video camera; the obtained images are displayed on the computer screen. However, it is only after thorough medical examination that doctors and surgeons will decide if thoracoscopic surgery can be done or not. For many patients, conventional open heart surgery is the best method.
- Robot-assisted cardiac surgery–This is a traditional open-chest surgery in which robotic arms are used by surgeons instead of their own arms. The surgeon will be working at a remote console. The heart can be viewed in a magnified 3-D high-definition view on a video monitor when the procedure is done on the patient. The hand movements of the robotic arms are controlled from the console by the surgeon and they are exactly like the way the real surgeon's arms would work. Along with functioning, it just looks as if a human arm is carrying out the surgery. There is a surgeon who assists the robotic hand at the operating table so that the surgical instruments attached to the robotic hands can be changed as per the needs.
Conditions to take into consideration before minimally invasive cardiac or open heart surgery?
A cardiac surgery – whether it is a minimally invasive one or an open heart – is quite complicated and considered as major surgery. The cardiac surgeon will have to keep many things in mind before suggesting surgery. In fact, he is the best person to guide as which kind of surgery will be most suitable for the patient. This is because conditions of all patients are not the same and the surgical procedure has to be decided accordingly.
- The first thing to take into consideration is the kind of heart ailment that the patient has.
- The second thing is the severity of the problem.
- Age is also an important factor to be taken into consideration for the surgery.
- The medical history and lifestyle of the person is also studied and understood
- Last but not least, the results of the tests and investigations done also help in understanding as what kind of surgery is most suitable for the patient.
Taking preparations for minimally invasive cardiac surgery
Once the final decision is taken that minimally invasive cardiac surgery will be able to cure your heart ailment, one has to take proper preparations for the same. The doctor will tell you what you need to do exactly. Generally, the patient is admitted to the hospital one-two days prior to the surgery. It is recommended not to eat or drink anything before the surgery, minimum for 8 hours at least. Also, the doctor might ask to stop taking some kinds of medicines before the surgery.
After the minimally invasive cardiac surgery
Once the surgery is complete, the patient will be shifted for a day or two to the Intensive Care Unit (ICU) in the hospital for proper and close observation. Medications, fluids and nutrition are all given through intravenous (IV) lines. Various kinds of tubes are also attached to the body for draining of urine or other kinds of fluids. Some people also might be given oxygen if needed. After two days or depending on the condition of the patient, he is shifted to the general room. However, the condition of the patient is monitored closely always. Pain and trauma is also managed well. Breathing exercises, walking and other kinds of activities are also recommended to patients while keeping their progress into consideration.
Regular follow-ups have to be done post-surgery and all instructions of the doctor have to be followed for a healthy heart and good life.
Dr. Zainulabedin Hamdulay is a renowned cardiothoracic surgeon based in Mumbai. He has attended more than 7000 cardiac surgeries & has an experience of over a decade. Currently he is the director of Masina Heart Institute, Mumbai. He is known for innovations & skills in cardiac surgery.