Types of Incisions Used in Minimally Invasive Heart Surgery

Partial Sternotomy - through part of the breast bone

A 3- to 4-inch long incision is made through the sternum, and the breast bone is separated in that area so the surgeon can see the part of the heart that needs surgery.

partial sternotomy

Used for mitral valve, tricuspid valve, epicardial lead placement, atrial septal defect (ASD), patent foramen ovale (PFO), myxoma, and aortic valve surgeries.

partial sternotomy

Used for ascending aorta, aortic valve, mitral valve, tricuspid valve, two valves, transaortic TAVR, ASD, PFO, myxoma and fibroblastoma surgeries.

Mini-thoracotomy

The surgeon avoids cutting through the breastbone and, instead, cuts into muscles between the ribs to reach the heart.

Mini-thoracotomy

Used for mitral valve, tricuspid valve, ASD, PFO, myxoma surgeries.

Mini-thoracotomy

Used for aortic valve, transaortic TAVR and transaortic TEVAR surgeries.

Mini-thoracotomy

Used for transapical TAVR, transapical TEVAR and epicardial lead placement surgeries.

Robotically assisted heart surgery

robotically assisted heart surgery

Used for mitral valve, tricuspid valve with mitral, ASD, PFO, atrial myxoma and fibroblastoma surgeries.

Robotically assisted heart surgery is performed through a small working incision and three other small incisions (ports) that are made in the spaces between the ribs. The surgical instruments are attached to the robotic arms. The instruments and a tiny camera are placed through the ports. Motion sensors are attached to the robotic “wrist,” so the surgeon can control the instruments.

Robotically assisted mitral valve surgery is performed using only the small port incisions.

Last reviewed by a Cleveland Clinic medical professional on 07/22/2019.

References

  • Gillinov M, Mihaljevic T. The Future of Mitral Valve Surgery. Tex Heart Inst J. 2012; 39(6):840–841. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528247/
  • Iribarne A, Easterwood R, Chan EYH, Yang J, Soni L, Russo MJ, Smith CR, Argenziano M. The golden age of minimally invasive cardiothoracic surgery: current and future perspectives. Future Cardiol. 2011 May; 7(3):333–346.
  • Johnston DR, Roselli EE. Minimally invasive aortic valve surgery: Cleveland Clinic experience. Ann Cardiothorac Surg 2015;4(2):140-147 :
  • Malaisrie SC, Barnhart GR, Farivar RS, Mehall J, Hummel B, Rodriguez E, Anderson M, Lewis C, Hargrove C, Ailawadi G, Goldman S, Khan J, Moront M, Grossi E, Roselli EE, Agnihotri A, Mack MJ, Smith JM, Thourani VH, Duhay FG, Kocis MT, Ryan WH. Current era minimally invasive aortic valve replacement: techniques and practice. J Thorac Cardiovasc Surg. 2014 Jan;147(1):6-14. Epub 2013 Nov 1.
  • Mihaljevic T, Koprivanac M, Kelava M, Avi Goodman A, Jarrett C, Williams SJ, Gillinov AM, Bajwa G, Bonatti J, Blackstone EH. Value of robotically assisted surgery for mitral valve disease. JAMA Surg. 2014 July; 149(7): 679-686.
  • Secchin Canale L, Mihaljevic T, Nair R, Bonatti J. Robotically assisted totally endoscopic coronary artery bypass surgery. J Thorac Dis. 2013 November; 5(Suppl 6): S641–S649.
  • Society of Thoracic Surgeons

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