Minimally invasive cardiac surgery
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Minimally Invasive Heart Surgery, also minimally invasive cardiac surgery/coronary artery bypass grafting (MICS CABG pronounced mix cabbage) or The McGinn Technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy
approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an aterolateral mini-thoracotomy.
Minimally Invasive Heart Surgery is favored by surgeons and patients because of reduced post-operative discomfort, faster healing times and lowered risk of infections or complications. This procedure makes heart surgery possible for patients who were previously considered to be too at risk for traditional surgery due to age or medical history. Patients referred for this procedure may have Coronary Artery Disease (CAD); triple Vessel Disease with median to large posterior descending artery (PDA); or previous unsuccessful stenting.
MICS CABG is performed through one window incision that stretches 5-7 cm in the 4th intercostal space (ICS). In some cases the thoractomy may be necessary in the 5th ICS instead. A soft tissue refractor is used to allow for greater visibility and access.
Two access incisions are also made at the 6th intercostal space and xphoid process to allow for operative Medtronic(r) instruments to pass through.
Once discharged form hospital patients require no further post-operative assistance.
ref>"Medtronic", "http://www.medtronic.com/mics/documents/200901133b_EN.pdf", 2009
Minimally invasive heart surgery procedures are a safe and broadly applicable technique for performing a wide range of complex heart procedures, including single or multiple heart valve procedures, bypass surgery, congenital heart repairs
.
Minimally invasive heart surgery has been used as an alternative to traditional surgery for the following procedures:
greatly reduces the trauma and pain associated with open-chest surgery and improves quality of life for patients. In the hospital, reduced post-operative discomfort enables patients to more quickly begin a much shorter recovery process with minimally invasive heart surgery. Most patients ambulate more easily and participate more actively in their personal care. Additionally, this approach lowers risk of complications such as bleeding and infection
.
Minimally invasive heart surgery dramatically improves cosmetic scarring. Rather than a prominent 10-inch scar down the middle of the chest, patients are left with smaller marks to the side of the ribs. For women in many cases, this scar is completely unnoticeable as it sits below the breast.
Benefits Include:
on January 21, 2005 at The Heart Institute at Staten Island University Hospital
in Staten Island
, New York
by a team led by Dr. Joseph McGinn. This technique is an Off-pump coronary artery bypass surgery. The procedure is much less invasive than traditional bypass surgery
because it's performed through three small incisions rather than the traditional sternotomy. Since its first procedure, over 600 MICS CABG procedures have been performed at The Heart Institute.
Minimally Invasive Heart Surgery, also minimally invasive cardiac surgery/coronary artery bypass grafting (MICS CABG pronounced mix cabbage) or The McGinn Technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy
Median sternotomy
Median sternotomy is a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or "cracked"...
approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an aterolateral mini-thoracotomy.
Minimally Invasive Heart Surgery is favored by surgeons and patients because of reduced post-operative discomfort, faster healing times and lowered risk of infections or complications. This procedure makes heart surgery possible for patients who were previously considered to be too at risk for traditional surgery due to age or medical history. Patients referred for this procedure may have Coronary Artery Disease (CAD); triple Vessel Disease with median to large posterior descending artery (PDA); or previous unsuccessful stenting.
The Procedure
MICS CABG is performed through one window incision that stretches 5-7 cm in the 4th intercostal space (ICS). In some cases the thoractomy may be necessary in the 5th ICS instead. A soft tissue refractor is used to allow for greater visibility and access.
Two access incisions are also made at the 6th intercostal space and xphoid process to allow for operative Medtronic(r) instruments to pass through.
Proximal Anastomoses/ McGinn Proximal Technique
The McGinn Proximal Technique is performed with blood pressure lowered to 90-100 systolic which reduces stress to the aorta making it easier to deal with and reducing the risk of damage. A series of tools are used to position and stabilize vessels. The technique uses special tools developed by Medtronic(r) guided through smaller incisions to support surrounding tissues.Pump-Assisted Beating Heart Bypass
A cannula with a pump and vacuum action is fed up through an artery in the groin to reduce the stress on the heart so that it may still function during the operation. This pump flows at 2-3L per minute to support circulation and eliminates the need for a heart-lung bypass machine.After Surgery
Using the McGinn Minimally Invasive technique patients recover more quickly than open-heart surgery and suffer less complications. Most patients can expect to resume all everyday activities within a few weeks of their operation. After surgery patients are administered with a pain pump and drains that will be removed after one day. Patients are encouraged to move around as much as possible after their operation to recover quickly.Once discharged form hospital patients require no further post-operative assistance.
ref>"Medtronic", "http://www.medtronic.com/mics/documents/200901133b_EN.pdf", 2009
Minimally invasive heart surgery procedures are a safe and broadly applicable technique for performing a wide range of complex heart procedures, including single or multiple heart valve procedures, bypass surgery, congenital heart repairs
Congenital heart defect
A congenital heart defect is a defect in the structure of the heart and great vessels which is present at birth. Many types of heart defects exist, most of which either obstruct blood flow in the heart or vessels near it, or cause blood to flow through the heart in an abnormal pattern. Other...
.
Minimally invasive heart surgery has been used as an alternative to traditional surgery for the following procedures:
- Mitral Valve Repair and ReplacementMitral valve repairMitral valve repair is a cardiac surgery procedure performed by cardiac surgeons to treat stenosis or regurgitation of the mitral valve. The mitral valve is the "inflow valve" for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, through the pulmonary veins, to the...
- Aortic Valve ReplacementAortic valve replacementAortic valve replacement is a cardiac surgery procedure in which a patient's failing aortic valve is replaced with an alternate healthy valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky or partially blocked...
- Atrial Septal DefectsAtrial septal defectAtrial septal defect is a form of congenital heart defect that enables blood flow between the left and right atria via the interatrial septum. The interatrial septum is the tissue that divides the right and left atria...
- Coronary Artery BypassCoronary artery bypass surgeryCoronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease...
Benefits of Minimally Invasive Heart Surgery
Eliminating the need for median sternotomyMedian sternotomy
Median sternotomy is a type of surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or "cracked"...
greatly reduces the trauma and pain associated with open-chest surgery and improves quality of life for patients. In the hospital, reduced post-operative discomfort enables patients to more quickly begin a much shorter recovery process with minimally invasive heart surgery. Most patients ambulate more easily and participate more actively in their personal care. Additionally, this approach lowers risk of complications such as bleeding and infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
.
Minimally invasive heart surgery dramatically improves cosmetic scarring. Rather than a prominent 10-inch scar down the middle of the chest, patients are left with smaller marks to the side of the ribs. For women in many cases, this scar is completely unnoticeable as it sits below the breast.
Benefits Include:
- No splitting of the breastbone
- Dramatic reduction in pain
- Lower risk of infection
- Lower risk of bleeding
- Reduced ICU and hospital stay
- Improved postoperative pulmonary function
- Accelerated recovery/return to activity
- Improved quality of life
- Greatly improved cosmetic result
History
The Minimally Invasive Cardiac Surgery was invented by Francis Duhaylongsod, a Filipino heart surgeon in Hawaii.The first minimally invasive heart cardiac surgery was performed in the United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
on January 21, 2005 at The Heart Institute at Staten Island University Hospital
Staten Island University Hospital
Staten Island University Hospital is a major tertiary referral center on Staten Island, in New York City.SIUH is a two-campus, 785-bed teaching hospital consisting of a North Campus, a South Campus, and the now closed Concord Campus....
in Staten Island
Staten Island
Staten Island is a borough of New York City, New York, United States, located in the southwest part of the city. Staten Island is separated from New Jersey by the Arthur Kill and the Kill Van Kull, and from the rest of New York by New York Bay...
, New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...
by a team led by Dr. Joseph McGinn. This technique is an Off-pump coronary artery bypass surgery. The procedure is much less invasive than traditional bypass surgery
Coronary artery bypass surgery
Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease...
because it's performed through three small incisions rather than the traditional sternotomy. Since its first procedure, over 600 MICS CABG procedures have been performed at The Heart Institute.