Minimally Invasive Heart Surgery (MIHS) refers to heart surgeries performed through smaller incisions compared to traditional open-heart surgery, which typically involves a large incision and splitting the breastbone. This approach aims to reduce pain, decrease recovery time, and minimize the risk of complications.


Techniques:

  • Mini-Thoracotomy: Surgeons make small incisions between the ribs to access the heart, often used for valve repair or replacement.

  • Robotic-Assisted Surgery: Utilizes robotic technology where the surgeon operates through small incisions using a console that controls robotic arms with surgical instruments and a high-resolution camera for precise manipulation.

  • Endoscopic Surgery: Uses a camera and long, thin instruments inserted through small incisions or natural body orifices to perform heart surgery with minimal tissue disruption.

  • Transcatheter Procedures: Involves threading a catheter through blood vessels to the heart to perform procedures like valve replacement (e.g., TAVR - Transcatheter Aortic Valve Replacement) or repair without opening the chest.


Indications:

  • Valve Disease: Such as mitral or aortic valve stenosis or regurgitation, where repair or replacement is needed.

  • Coronary Artery Disease: For patients needing bypass surgery, particularly when only one or two arteries are involved.

  • Atrial Septal Defect (ASD): For repairing holes in the heart's septum between the atria.

  • Arrhythmias: Techniques like the Maze procedure for atrial fibrillation can be performed minimally invasively.


Types of Minimally Invasive Heart Surgery:

  • Minimally Invasive Valve Surgery: Includes repair or replacement of mitral, aortic, or tricuspid valves through small incisions or catheter-based approaches.

  • Minimally Invasive Coronary Artery Bypass Grafting (MIDCAB): A bypass surgery through small incisions, often used for single or double vessel disease.

  • Transcatheter Aortic Valve Replacement (TAVR): A procedure to replace the aortic valve without removing the old one, suitable for high-risk surgical patients.

  • Minimally Invasive Maze Procedure: For treating atrial fibrillation by creating scar tissue to disrupt abnormal electrical circuits in the heart.

  • Atrial Septal Defect Repair: Through small incisions or catheter techniques.


Minimally invasive heart surgery offers several advantages, including less postoperative pain, smaller scars, quicker recovery, and reduced infection risk. However, it requires specialized equipment and surgeon expertise, might not be suitable for all patients or all types of heart surgeries, and can be more technically challenging.


These insights are drawn from various sources discussing minimally invasive cardiac procedures, their techniques, and indications.