Minimally invasive heart surgery (also called keyhole surgery) is when a conventional operation is performed on or inside the heart using small incisions. The surgeon also sometimes uses specialized instruments.
Who Is a Candidate for Minimally Invasive or Robotic Surgery?
There are many ways to reach the heart for surgery. Surgeons at Cleveland Clinic always try to use the smallest incision to provide the safest and most successful surgery. Your surgical team will carefully compare the advantages and disadvantages of minimally invasive techniques with those of traditional surgery techniques. Your surgeon will decide the best approach for you based on several factors, including the type or heart disease you have and how severe it is; your age, medical history and lifestyle; and results of tests done before surgery.
Traditional Heart Surgery
Traditional heart surgery uses an incision through the middle of your chest, through the breast bone. The incision is about 6 to 8 inches long.
This is the safest and most commonly used incision for patients who need complicated heart surgeries, reoperations, multiple coronary artery bypass procedures or complex aorta procedures.
Types of Minimally Invasive Heart Surgeries
Cleveland Clinic surgeons have performed minimally invasive heart surgery since the mid 1990s. The first surgeries of this type were mitral and aortic valve surgeries. Now, a wide range of procedures can be done using minimally invasive techniques to help make recovery faster and more comfortable.
Sometimes, minimally invasive surgery includes a partial sternotomy. This involves cutting through part of the breast bone. When possible, the surgeon can avoid cutting the breast bone and, instead, make one or more small incisions through the muscles between the ribs. This technique is called a mini-thoracotomy.
Robotically assisted heart surgery
Most types of robotically assisted heart surgery are used to treat patients with mitral regurgitation (leaky mitral valve). Robotically assisted heart surgery can be used for:
- Mitral valve repair
- Tricuspid valve repair (with mitral valve repair)
- Ablation of atrial fibrillation (if other robotic surgery is required)
- Atrial septal defect (ASD) repair
- Patent foramen ovale (PFO) repair
- Removal of cardiac tumors (Myxoma, Fibroelastoma of the mitral or tricuspid valve)