MINIMALLY INVASIVE SURGERY
What are the conditions for which minimally invasive cardiac surgery can be done?
There are various kinds of cardiac procedures for which minimally invasive cardiac surgery can be done. Some of them are as follows:
- Valve surgery – both aortic valve and mitral valve
- Coronary bypass
- Aneurysm repair
- Congenital cardiac disease
What happens during minimally invasive cardiac surgery?
As it has been already mentioned, in the process of minimally invasive cardiac surgery, small incisions are made in between the ribs/sternum. It is through these incisions that small tools and equipment’s are inserted inside the body and they are controlled from outside via a computer. Also known as robotic assisted surgery, an electronic operating station is needed for this kind of surgery to take place. It is from this station that the surgeon controls the whole process with robotic arms and a high-definition
camera.
Anesthesia is administered so that no pain is felt during the surgery. Once the incisions are made, the tools are inserted through the incisions. Different tools are inserted through different incisions and the whole process is controlled by the surgeon via a computerized device. The surgical tools are integrated with robotic hands and the doctor controls the hands carrying out the surgery. The instruments are completely controlled and manipulated by the doctor via the device and the procedure can be
completed more precisely.
Once the surgery is done successfully, all the equipments and tools are removed out of the body through the same incisions. The incisions are then stitched and the procedure is complete. Both aortic and mitral valve surgeries have seen great results with this kind of surgery.
What are the benefits of minimally invasive cardiac surgery?
Since minimally invasive cardiac surgery does not need making any kinds of deep and large incisions, there are many benefits from the process. Some of the prominent ones are as follows:
- Leads to minimum blood loss during the surgical process
- Smaller and fewer incisions need to be made on the body
- Lesser damage to cells, tissues and muscles
- Lesser pain and less period of hospital stay
- Less chances of infection
- Quicker healing and faster recovery time
- Less visible scars
Risks of minimally invasive cardiac surgery
All kinds of surgeries come with their share of risks and complications. There might be risks with the anesthesia or chances of infections at the site of the incisions. Also, since the tools and equipment’s in this kind of surgery are controlled and manipulated from outside by the surgeon, a small error can prove to be highly risky. This is the reason all patients are not suitable for this kind of surgery. After checking all the reports, the health condition and age of the patient, the doctor will decide if minimally invasive cardiac surgery can be done. For some patients, the conventional surgery is the safer and less-risky way.
A patient is kept in the hospital for about 3-5 days, depending on the condition. It takes about 2-4 weeks to recover from the surgery completely and resume daily activities. There will still be some restrictions and precautions that need to be taken. It is also recommended to take the medications as prescribed and suggested by the doctor thoroughly and sincerely. Complete cure is possible taking into consideration that the surgery is done on time and the instructions are followed religiously.
Sutureless Valve Surgery
The human heart is a complex organ. There are different valves in the heart, which help in controlling the flow of blood to and from the heart. Problems with the valve can hamper the proper functioning of the heart, leading to various kinds of health problems.
Aortic stenosis is one common problem which is seen in many cardiac patients. In this ailment, the aortic valve narrows down considerably, mainly due to calcification. This valve helps in separating the main pumping chamber of the heart from the system which circulates blood all throughout the body. With a narrowed aortic valve, blood flow out of the heart is reduced. This can lead to various kinds of cardiac complications. The aortic valve needs to be repaired or replaced as per the need of the patient.
Most common symptoms of aortic stenosis include shortness of breath, chest pains and fainting. The most dangerous thing is that the ailment remains asymptomatic for a long time. But when symptoms start showing, it progresses really fast. If surgery is not done within a short span of time, the chances of the patient’s survival are doubtful.
Surgical aortic valve replacement is the conventional treatment, which should be provided to patient with severe symptomatic aortic stenosis. However, there might be many other medical factors which might make this kind of surgery difficult for the surgeon as well as for the patient. Usually medications are provided to such patients to provide the maximum amount of support that is possible.
The process and procedure of suture less valve surgery
When you are looking for alternatives for conventional aortic valve replacement or even transcatheter aortic valve implantation, the only alternative left is suture less valve surgery. The problematic and damaged valve is removed in the process and problems of the coronary arteries and aortic valves can be treated at the same time in this kind of surgery. Moreover, the time taken for this surgery is not very long as the new valve does not need to be sewn. As a result, aortic cross-clamp times and cardiopulmonary times are minimized considerably.
The patient is mainly put under general anesthesia for such a surgery. The heart is accessed through a mini or full sternotomy. Once cardioplegia and cardiopulmonary bypass machine is set up, the damaged aortic valve is replaced and removed through the incision in the aorta. Calcifications around the native aortic annulus are removed for better and smooth valve implantation. The valve prosthesis, which will be implanted in place of the damaged valve, is placed on a delivery device and inserted into the native annulus with 1 or more stitches. Once the valve is released, the stitches are removed. The functioning and the positioning of the new valve is checked again and again post-surgery with the help of transoesphageal echocardiography.
Stay in the hospital and recovery
A patient who has undergone suture less valve surgery will need to be at the hospital for couple of days under observation in case any kinds of complications and problems rise. All the vitals are monitored from time to time and strict monitoring is done on the heart function to understand that the newly implanted valve is working well.
At the time of discharge, the patient is given a set of instructions and guidelines which need to be followed strictly. There will be some restrictions initially, which have to be followed. Various kinds of medications are also prescribed which should be taken timely. The doctor will provide a follow up date and that appointment shouldn’t be missed.
