What cardiac surgeries are performed through minimally invasive techniques?
Minimally invasive surgery – either a catheter-based or robotic technique – is used to treat conditions due to abnormalities of the heart’s valves and other structures. Minimally invasive surgery, versus the conventional open surgical technique, can be used to perform the following procedures:
- Robotic mitral valve repair or replacement
- Transcatheter aortic valve replacement (TAVR) for aortic stenosis or failed prosthetic valves in high-risk or inoperable patients
- Percutaneous mitral valve repair
- Balloon mitral valvuloplasty for rheumatic mitral stenosis
- Mitraclip for mitral regurgitation for poor surgical candidates
- Robotic-assisted coronary artery bypass grafting (minimally invasive surgical LIMA to LAD bypass), often using a hybrid approach combined with coronary artery stenting to other vessels
- Catheter-based and robotic-assisted ablation for atrial fibrillation
- Resection of intracardiac tumors
- Closure of adult-acquired or congenital heart defects (for example, atrial and ventricular septal defects, patent foramen ovale and prosthetic perivalvular regurgitation)
What patients are candidates for minimally invasive heart surgery?
- Most patients with mitral valve disease, as long as they do not need additional cardiac procedures such as coronary bypass surgery or repair/replacement of an additional valve
- Patients with aortic stenosis, failed aortic valve prosthetic valves or mitral regurgitation who are at high risk for conventional surgery
- Most patients who require closure of an atrial septal defect, patent foramen ovale or resection of an atrial tumor (e.g., myoxoma)
- Patients with atrial fibrillation who are candidates for ablation or are at high risk of thromboembolic stroke
- Carefully-selected patients who require coronary revascularization where the advantages of a left internal mammary graft to the LAD can be safely combined with coronary artery stenting to avoid need for a sternotomy and need for saphenous vein grafts
What are the benefits of minimally invasive heart surgery?
- Smaller incisions – Minimally invasive surgery uses small percutaneous incisions and “keyhole” ports rather than conventional open chest incisions (typically sternotomy).
- Catheter procedures do not need to stop the heart and avoid the heart-lung machine.
- Greater precision – The daVinci® robot provides surgeons better visibility and views, as well as improved dexterity throughout the surgical process.
- Faster recovery – Avoiding a large incision required with conventional surgical procedures and leaving the breastbone intact reduces recovery time and gets patients back to their routine faster.
- The approaches have equivalent or superior results with same or less risk to the patient.
- There is greater patient satisfaction with minimally invasive surgery.