Minimally-invasive cardiac surgery is defined as open heart surgery performed through relatively small, less invasive incisions in the chest that avoid or minimize cutting the patient’s ribs or sternum (breast bone). Dr. Clarence H. Owen successfully performed the first minimally-invasive mitral valve repair operation at Moses Cone Memorial Hospital in 2009. Since then a variety of complex heart valve operations have been performed using minimally invasive techniques on a high volume of carefully selected patients.
Procedures that are performed routinely using minimally-invasive techniques include mitral valve repair, mitral valve replacement, aortic valve replacement, tricuspid valve repair, maze procedure, closure of atrial septal defect, and resection of atrial myxoma or other cardiac tumors.
Potential advantages of minimally invasive heart valve surgery include smaller smaller, cosmetically more appealing incisions, decreased blood loss, decreased pain, shorter hospital stay, a quicker return to normal activity, improved visualization of the mitral valve, and decreased risk in selected cases (reoperations).
Potential disadvantages of minimally invasive heart valve surgery include limited access to the heart and great vessels, longer duration of surgery, the potential for complications related to the surgical approach, and some added costs for instrumentation.
Minimally invasive heart valve operations differ from conventional open heart surgery by the size and location of the incision, limited exposure of the external surface of the heart, attachment of the patient to a heart-lung machine using specialized cannulas often placed through an incision in the groin, specially designed instrumentation, and video assisted visualization with or without robotic assistance. The techniques utilized to repair or replace the heart valve are usually not different, and the patient’s outcome should not be compromised.