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Transcript for Minimally Invasive Heart Surgery

Tomislav Mihaljevic, MD
Video by Tomislav Mihaljevic, MD

Specialties: Minimally invasive cardiac surgery, image-guided cardiac surgery, robotics in cardiac surgery, heart failure, mitral and aortic valve repair and replacement, coronary artery disease, beating heart revascularization, Maze procedure, heart and lung transplantation, ventricular assist devices, and adult congenital heart disease.

Hello, my name is Tomislav Mihaljevic and I’m a heart surgeon at the Cleveland Clinic. Today, I would like to talk a little bit about minimally invasive heart surgical operations.

As you know there is a lot of interest for minimally invasive surgery and here at the Cleveland Clinic only last year we preformed more than 500 minimally invasive heart operations. Minimally invasive surgery can be applied in many different settings. And one of the most common minimally invasive procedures is procedures performed on the aortic and the mitral valve.

We have done a number of minimally invasive mitral valve procedures, as well as aortic valve replacements, and most of these operations can be preformed through a very small incision. For example, the length of the standard incision in cardiac surgery is about four to five inches. With the minimally invasive approach, we can reduce the size of incision to two and a half to three inches only.

There are number of advantages to minimally invasive procedures. The major advantage is there is a less trauma to the patient. The less trauma to the patient translates into a faster recovery after cardiac operations and a shorter length of stay in a hospital. The majority of our patients stay in the hospital only three to five days after the surgery and then when they go home, they are usually capable of independent living. They go back to work within two to three weeks after the operation. That is obviously a significant advantage compared to the recovery after standard operations that takes almost twice as much time.

There are a number of other operations that can also be performed through the minimally invasive procedures, such as coronary artery bypass surgery, as well as the placement of the pacemaker which leads to the treatment of advanced congestive heart failure.

There are also other instrumentations that can be used for the minimally invasive approach to cardiac surgery, such as robotic instruments. Robotic surgery today can be used for the performance of the coronary artery bypass grafting for bypass surgery. It can also be used for the certain valve replacements, such as the mitral valve repair, and it also has been successfully used for the performance of the pacemaker surgery for patients who have advanced congestive heart failure.

Very many patients ask about their suitability for minimally invasive heart operations. Are they candidates and who are the candidates for minimally invasive cardiac surgery? What we can say is that the majority of the patients who require the operations only on the aortic or only on the mitral valve are certainly likely to be candidates for minimally invasive approaches. Those patients however, who require the combined operations that involve the operations on the heart valves as well as the bypass surgery are probably going to require a standard approach with the standard incision.

We are certainly convinced that the minimally invasive approaches are beneficial to our patients. The results from the minimally invasive approaches are certainly comparable to those with the standard incisions. However, the recovery is much faster and therefore we think that this approach is advantageous to our patients. So this was a short introduction to the minimal invasive here at the Cleveland Clinic. Thank for your attention.

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Reviewed: 04/11

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