What is minimal invasive cardiac surgery (MICAS)?
Minimally invasive heart surgery (also called keyhole surgery) is a newer form of cardiac surgery. In this type of heart surgery, small incisions are done, without dividing the central breastbone or sternum. That means instead of "cutting open the chest" from midline as they do with traditional open heart surgery, a small and cosmetic incisions using specialized instruments is used for procedure.
How is the procedure carried out?
MICS procedure is carried out through a small 5 cm incision on the side of the chest (mini thoracotomy) without damaging any bones. In females, the incision is under the breast fold making it even more cosmetic.
Similar to a regular heart surgery, the operation is performed using
all arteries or a combination of arteries and veins removed from the leg.
The vessel from the leg in these operations is also removed endoscopically without cutting the skin over the leg.
Special instruments, camera and cannulas are used for performing the surgery through this small incision.
Is MICAS CABG a beating heart operation?
Yes, it is an off pump or beating heart operation. The support of a pump may rarely be required but the operation is still performed on the beating heart. Pump support may particularly be used when the heart is weak.
What are the Common Indications of the MICAS? :
Coronary artery disease - Minimally invasive coronary artery bypass
Cardiac rhythm disorders- Minimally invasive atrial fibrillation ablation
Mitral valve disease- Minimally invasive mitral valve repair placement/repair
Aortic valve disease- Minimally invasive aortic valve replacement/repair.
Congenital cardiac disease
Removal of cardiac tumours
How does it differ from conventional cardiac surgery?
No bones are cut like in conventional heart surgery hence reducing pain, retaining function and having a positive effect on breathing.
The incision measures just 2-3inches which makes it impossible to tell that a heart surgery has been performed.
The return to normal life is faster and patient can perform daily activities like including driving or other activities without any disruption.
Blood loss is almost negligible and therefore eliminating blood transfusion and eliminating blood borne infection.
The procedure is ideal in diabetics and older patients who have poor resistance to infections as all infections are reduced whether it is wound infections or post-surgical lung infection.
The procedure lasts only 4 days.
What are the contraindications for the surgery?
Acute myocardial infarction
Severe peripheral vascular disease (arteries and veins)
Severe left ventricular dysfunction of the heart
What are the benefits of MININMAL INVASIVE cardiac surgery?
Faster recovery to normal work
Small cosmetic incision
Lesser blood loss and reduced amount of blood transfusions
Lesser chances of infection
Better wound healing
Earlier mobilisation and shorter hospital stay after surgery in ICU
Better quality of life after surgery
What is the risk of infections after MICAS CABG?
The risk of infection is close to zero. All infections are reduced dramatically in MICS CABG even in diabetics. It is due to the fact that the incision is small and no bone is fractured.
What are the precautions I would have to take after MICS?
After minimally invasive heart surgery, you may have an improved quality of life and reduced symptoms.
Incorporate healthy lifestyle changes — such as physical activity, a healthy diet, stress management and avoiding tobacco use — into your life.
Your doctor will instruct you about when you can return to daily activities, such as working, driving and exercise. Attend regular follow-up appointments with your doctor. You may have several tests to evaluate and monitor your condition.
Participate in cardiac rehabilitation — a program of education and exercise designed to help you improve your health and help you recover after heart surgery.
To keep your heart healthy after surgery, it is important to make lifestyle changes and take your medications as prescribed.
To know more about Minimal Invasive Cardiac Surgery please Visit us at Wockhardt Hospital, Mira Road .Understand all your cardiac conditions with our experienced cardiac surgeons.
He has over 9 years of experience and has operated more than 5000 cases in his field. He specialises in Minimal Invasive Cardiac Surgery at the hospital.
Angioplasty is a specialised procedure performed in a Cath lab (cardiac catheterisation laboratory). Since the patients are awake and alert through the procedure, they are given medication before and during angioplasty procedure to help relax
Coronary angiography is an imaging technique or a radiological test that helps visualize the insides of the coronary arteries. It shows the exact location and severity of any plaque formation and consequent narrowing of the coronary arteries. This helps the doctor to decide on what treatment is needed.
Our heart is located in our chest cavity and is a pump made of special muscles known as myocardium. Our heart is divided into four chambers; two upper chambers known as auricles (atria) and two lower chambers are known as ventricles. They are interconnected by a passage and the opening and closing is controlled by valves.
Arteries, veins and lymphatic vessels form the vascular system of our body and vascular surgery is a specialty dealing with diseases affecting the vascular system The diseases affecting our vascular system involve the obstruction in the blood flow due to blockages (aneurysms) in the vessels.
Heart valve surgery is used to repair or replace diseased heart valves. Blood flows between different chambers of the heart must flow through a heart valve. Human heart has four valves namely Tricuspid, Pulmonary, Mitral and Aortic Valves. If a valve is not working correctly, blood flow is impaired either by leakage or by back flow.
The rhythmicity of the heart beat is based on the electric impulses. These impulses are initiated by the contraction of the cardiac muscles also known as myocardium.
Electrophysiology is a branch of cardiology that deals with the diagnosis and treatment of heart rhythm disorders. Electrophysiologists are the cardiologists with special training in heart rhythms disorders and its management.
Heart Surgery may be required to fix the problem with the functioning of the heart. Closed heart surgery does not require patients to be supported by a heart-lung bypass machine and the heart chambers are opened during the procedure. Some repairs are best performed using closed heart surgery.
Heart surgery in children are indicated to repair heart defects a child is born with CHD (congenital heart defects) and heart diseases a child gets after birth. The surgery is needed for the child's wellbeing. There are many kinds of heart defects ranging from minor to serious.
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). Symptoms of coronary artery disease include chest pain, fatigue, palpitations, abnormal heart rhythms and shortness of breath.
Pacemaker implantation is a surgical procedure where a small electrical device called a pacemaker is implanted on the chest or abdomen. The pacemaker sends regular electrical pulses that help keep your heart beating regularly.
Heart valve surgery fixes a damaged or faulty heart valve. There are two main types of heart valve surgeries: valve repair and valve replacement. Double valve surgery is a surgery where two valves are involved. Sometimes a faulty valve can be repaired by cutting away excess tissue in the cusps of the valve and sewing the edges together.
A ventricular septal defect (VSD) is an opening or hole in the wall that separates the two lower chambers of the heart. This wall is the ventricular septum. The hole causes oxygen-rich blood to leak from the left side of the heart to the right side.
The upper chambers of the heart are divided a wall called “interatrial septum”. The defect in this wall is known as Atrial septal defect (ASD). It is a form of a congenital heart defect, the defect the baby is born with.