Minimally Invasive Heart Surgery

What is minimally invasive heart surgery?

Minimally invasive heart surgery is a term for heart procedures performed through one or more small cuts (incisions). In contrast, open-heart surgeries typically use one long incision down the front of your chest.

Surgeons insert small, high-powered cameras, tools or robotic arms through the incisions. The surgeon guides the tools between your ribs to access your heart. Minimally invasive techniques may offer less scarring, reduced pain and faster healing than open-heart surgeries. Open-heart surgeries typically involve cutting through your breastbone (sternum) to reach your heart.

What are the types of minimally invasive heart surgery?

There are two main types of minimally invasive heart surgery:

• Thoracoscopic surgery: Your surgeon makes one or more small incisions in the side of your chest. They insert a long tube with a video camera (thoracoscope) through the incisions to view your heart. They operate using long, thin tools.
• Robotically assisted heart surgery: Your surgeon makes one or more small incisions in the side of your chest. They guide robotic arms through the incisions. The robot shows clear images of your heart, and your surgeon controls the robotic arms to perform the procedure.

What is minimally invasive heart surgery used for?

Surgeons may use minimally invasive techniques for a variety of surgeries, including:

• Atrial septal defect (ASD) closure.
• Atrioventricular canal defect surgery.
• Cardiac tumor removal.
• Coronary artery bypass surgery.
• Maze procedure for atrial fibrillation.
• Patent foramen ovale (PFO) closure.
• Valve repairs or replacements, including minimally invasive mitral valve repair.
• Ventricular assist device placement.

Is minimally invasive heart surgery safe?

Yes. There is a risk of complications with any type of surgery. However, minimally invasive surgeries often have lower complication rates than open procedures.

What happens before minimally invasive heart surgery?

Your surgeon will give you instructions to prepare for minimally invasive heart surgery. You may need to stop taking some medications for a short period before the procedure.

You’ll receive general anesthesia to remain asleep during the surgery. You may have a small patch of hair shaved where your surgeon will make the incisions. Your surgical team will connect you to a heart-lung machine that keeps blood circulating during the operation.

What happens during minimally invasive heart surgery?

During minimally invasive heart surgery, a cardiac surgeon will:

1. Make one or more small incisions on the side of your chest.
2. Insert small surgical tools or robotic arms through the incisions.
3. Guide the tools between your ribs to reach your heart.
4. Repair your heart, replace a heart valve, place a device or remove tumors.
5. Close the incisions with stitches.

How long does minimally invasive heart surgery take?

Minimally invasive heart surgery usually takes about two to six hours.

What happens after minimally invasive heart surgery?

You'll typically spend one to two days in the intensive care unit (ICU) after minimally invasive heart surgery. You may have drainage tubes in your chest to prevent fluid buildup around your heart.

You'll recover for a few more days in another area of the hospital. Your surgical team will help you get up and walk within a day or two of surgery. They may instruct you to perform breathing exercises to keep fluid out of your lungs. Generally, people stay in the hospital for a few days. The total amount of time you spend in the hospital will depend on the specific condition and type of surgery you have.

What are the advantages of minimally invasive heart surgery?

Compared to open-heart surgery, minimally invasive heart surgery may offer benefits such as:

• Faster recovery.
• Less blood loss.
• Less visible scars.
• Lower risk of bleeding or infection.
• Reduced pain.
• Shorter hospital stays.

What are the risks or complications of minimally invasive heart surgery?

Minimally invasive heart surgery has a lower risk of complications than open-heart surgery. But there's still a risk of:

• Bleeding.
• Infection.
• Irregular heartbeats (arrhythmias).
• Stroke.

Sometimes, your surgeon may switch to open techniques partway through surgery if they determine that the minimally invasive approach is no longer safe. This isn’t common, but it’s important to understand that it’s possible.

How long does it take to recover from minimally invasive heart surgery?

You may feel more tired than usual for a few weeks after surgery. Your surgeon will give you instructions about when you can return to work and other activities such as driving, exercising and working. Most people return to their usual activities within two to four weeks. You’ll need to avoid heavy lifting for several weeks.

Your provider may also recommend that you complete a cardiac rehabilitation program to increase your activity levels safely. These programs may also help you adopt healthier habits, such as consistent exercise and eating a heart-healthy diet.

When should I see my healthcare provider?

See your healthcare provider right away if you experience any signs of complication after minimally invasive heart surgery, including:

• Drainage or pus around the incision site.
• Excessive swelling or redness around the incision site.
• Fever or chills.
• Heart palpitations.
• Unusual swelling or fluid retention (edema) in your legs or feet.
• Weight gain of more than three pounds in one week.

A note from Cleveland Clinic

Minimally invasive heart surgeries are operations that surgeons perform through one or more small incisions in your chest. These procedures are less invasive than open-heart surgeries. Open-heart surgeries use one long incision down the center of your chest. Surgeons may use minimally invasive techniques to repair heart valves, remove tumors or correct heart defects. Minimally invasive heart surgery often leads to less pain, smaller scars and faster recovery.