PERFORMING MINIMALLY INVASIVE HEART SURGERY

Minimally invasive heart surgery is performed without opening the chest, as in conventional open heart surgery. Instead of a large incision down the center of the chest and through the breastbone, minimally invasive surgery is performed through a small incision, and thus generally results in fewer complications, quicker recovery time, and smaller scars.

Minimally invasive approaches are applied to surgical coronary revascularization and heart valve replacement.

Among the new-style heart operations we perform at Stony Brook is minimally invasive direct coronary artery bypass (MIDCAB) surgery. Compared with standard techniques, this procedure offers a less invasive surgical approach for bypassing blocked coronary arteries. Not only is the incision smaller (3–4 inches), the heart is not stopped during the repair, as in conventional bypass surgery.

The strict definition of a MIDCAB procedure is coronary bypass surgery done without sternotomy (whereby the breastbone is split, the ribcage pried apart, and the operation performed through a 12- to 15-inch incision down the middle of the chest), without cardioplegia (whereby the heart is stopped), and without cardiopulmonary bypass (whereby the stopped heart's work is taken over by a heart-lung machine).

MIDCAB surgery has been offered at University Hospital since the spring of 1997. In the first year of its use, nearly 100 operations have been performed, and the response from the medical community has been enthusiastic.

Dr. Frank C. Seifert, of our Division of Cardiothoracic Surgery, has been assigned to lead the Division in minimally invasive heart surgery, including MIDCAB and valve surgery through mini-sternotomy.

Commenting on our pioneering use of MIDCAB, Dr. Seifert explains: "Patients are very positive about the surgery, and benefit greatly from the shortened recovery period. In the fall of 1997, we initiated multi-vessel MIDCAB surgery, as we continue to expand the indications for this procedure in selected patients with triple-vessel coronary artery disease."

MIDCAB and More

Other minimally invasive techniques such as "mini-valve" surgery are being pioneered at Stony Brook. Aortic valves can now be replaced through a 3-inch incision with conventional bypass. Patients recover quickly and are sent home pain-free, fully functional within 48 hours of their operation.

The development of such techniques as MIDCAB and mini-valve surgery has expanded our surgical armamentarium and allowed extrapolation to more complicated aneurysm surgery and also ventricular remodeling (the new Batista operation for congestive heart failure).

Minimally invasive techniques are playing an increasing role in cardiac surgery. Patients need to be aware, however, that no single minimally invasive technique is applicable to all cases, and that at present more traditional surgery may be indicated.

With the breadth of experience and availability of new techniques at Stony Brook's University Hospital and Medical Center, our strength is the ability to provide individual patients with the most appropriate surgery for their condition.

For more information about minimally invasive heart surgery at Stony Brook, please call 631-444-1820 to arrange for a consultation/appointment with one of our cardiothoracic surgeons.