Minimally Invasive Cardiac Surgery

What is minimally invasive cardiac surgery?

Minimally invasive cardiac surgery is a set of techniques in which surgeons perform operations through very small incisions — roughly the size of a paper clip.

Conditions that can be treated with minimally invasive cardiac surgery include:

• atrial septal defect
• ventricular septal defect
• complete AV canal defects
• tetralogy of fallot (for some patients)
• vascular ring
• right aortic arch with aberrant left subclavian
• double aortic arch

How does minimally invasive cardiac surgery differ from conventional open heart surgery?

If your child undergoes an open-heart surgical procedure that requires the use of a heart-lung bypass machine:

• the surgeon has to make a full incision across the sternum (breastbone), resulting in a very visible scar
• the sternum will need to be wired, and healing of the bone would take six to eight weeks

What are the benefits of minimally invasive cardiac surgery?

The benefits of minimally invasive cardiac surgery can be many, including:

• a few small incisions, instead of a long incision through the breastbone
• less damage to tissue and muscle
• less pain
• less scarring
• less blood loss
• shorter stay in the hospital
• faster return to normal activities
• in some cases, the use of a heart-lung machine may not be needed, thus avoiding extra risks associated with bypass, such as clots

The minimally invasive surgery difference

• The minimally invasive approach involves a very small skin incision, which can be as short as 3.5 centimeters.
• Sometimes, there doesn’t need to be an incision in the sternum at all. The tiny incision can be positioned in your child’s mid-chest, where the scar is not nearly as noticeable.
• In other cases, only part of the sternum needs to be divided to access the heart. In children, the sternum is flexible enough that the lower two halves can be separated. This allows enough room for the introduction of the special instruments used to perform the surgery.
• Recovery from this procedure takes much less time than traditional methods. Your child will most likely be fully mobile and able to bear weight with the arms within a short time.

What is video assisted thoracoscopic surgery?

Video assisted thoracoscopic surgery is a type of minimally invasive cardiac surgical procedure.

During the procedure, a video scope is introduced into the chest through a "port" just a few millimeters in length. Three other ports allow for the introduction of instruments necessary to do the work.

Just like with other kinds of minimally invasive surgery, video assisted technique means a quicker recovery and lessened pain at the incision site for your child.

We have used this approach here at Boston Children’s to close patent ductus arteriousus and to divide vascular rings, and researchers are actively looking into expanding the application of this kind of surgery to other cardiac defects.