It’s not your father’s heart surgery anymore.
Only a few short years ago, anyone requiring heart surgery was facing several certainties: a 12 inch scar, having their heart temporarily stopped while being attached to a heart lung machine, spending weeks in the hospital after surgery, and enduring months of recovery and pain from the surgical saw used to cut through the sternum (breast bone) to “crack the chest”. In 2011? Nearly everything has changed.
The difference is simple: the rise of the minimally invasive approach to heart surgery. The technique has revolutionized cardiac surgery for the patient.
A term that is used frequently but seldom explained, minimally invasive surgery has one key difference for the patient: no bone saw, no splitting of the breast bone, no “cracking of the chest”.
“Minimally invasive cardiac surgery allows a non-sternotomy approach, where the incision is made between the ribs without breaking bone,” says Michael Rosenbloom, MD, Director of Cardiothoracic Surgery at Cooper University Hospital. “In terms of incision size, pain and recovery time, the difference is night and day for the patient.”
A minimally invasive approach also allows for off-pump, or beating heart surgery – eliminating the need, and possible complications associated with the heart-lung machine.
“This approach enables us to design an operation for each patient that reduces the chance of short-term complications, achieves better long-term results, and most importantly, meets the needs of the patient,” explains Richard Y. Highbloom, MD, a Cooper cardiothoracic surgeon. “This individualized approach allows us to perform procedures off-pump, robotic assisted, or even bloodless surgery.” These benefits beg the question: Why aren’t all heart surgeries performed using minimally invasive techniques?
Minimally invasive surgery requires a great deal of technical expertise, and a skilled team,” says Cooper cardiothoracic surgeon Frank W. Bowen III, MD. “Not every surgeon and center is equipped to offer the approach to patients.”
Finding the Best Minimally Invasive Heart Surgery Program: The Top Five Questions to Ask
According to leading consumer health advocacy centers, selecting the best surgeon and the best center takes investigation and asking the right questions. For heart surgery, those questions include:
- How often is minimally invasive cardiac surgery performed?
With any complex procedure, experience matters. Cardiac Surgery Centers with the highest volume of cases performed via minimally invasive approach will have the best outcomes.
- What are the surgeons outcomes for minimally invasive heart surgery?
The expertise of a cardiac surgeon in performing a procedure is as important as the number of cases. Investigate the minimally invasive outcomes of the cardiac surgeons who would perform the procedure.
- Do the cardiac surgeons use innovative techniques?
In selecting a cardiac surgery center and surgeon, it is important to investigate if surgeons offer innovative approaches to traditional surgical procedures, such as use of both the right and left internal mammary arteries in coronary artery bypass surgery.
- Do the cardiac surgeons perform minimally invasive valve surgery?
Mitral valve and aortic valve surgery can be performed successfully using a minimally invasive approach, but there must be a high level of technical expertise. Does the cardiac surgeon and center you are investigating offer minimal access valve surgery frequently to patients who would benefit from the procedure? What are their outcomes?
- Who does your physician recommend?
Physicians are well informed about the hospitals and cardiac surgery centers in their area. Ask him/her who has the best outcomes with minimally invasive surgery? Which hospital has a round-the-clock multidisciplinary care physician team for the critical first hours after surgery?
At Cooper University Hospital cardiac surgeons perform 91 percent of coronary artery bypass surgeries without the use of the heart-lung machine. The Cooper cardiovascular surgery program recently received a three-star ranking from the Society for Thoracic Surgeons (STS) for the third straight year, and is ranked in the top 13 percent of programs in the nation. In addition, Cooper University Hospital is an acknowledged expert in the area for minimally invasive valve repair, and has a highest use of innovative procedures such as bypass grafting with both the right and left internal mammary arteries, in the Delaware Valley.
Minimally Invasive Is Preferred, but Not Always an Option
The benefits of minimally invasive cardiac surgery are many; however, it is important to understand it is not an approach that can be used for all cardiac procedures.
“There are some contraindications for a minimally invasive approach, such as the need for multiple heart procedures to be performed during the same surgery, and in some cases where the patient has had previous heart or lung surgery, ” says Dr. Rosenbloom. It is important to select a surgeon who will review your case carefully to determine if a minimal access approach is the most beneficial for you.”
For more information, or to make an appointment with Cooper cardiovascular surgeons call: 1-800-8-COOPER.