Minimally Invasive Heart Surgery

Minimally Invasive Heart Surgery

By Allen Cheng, MD

In minimally invasive heart surgery (MIS), also known as keyhole surgery, the surgeon performs heart surgery through small incisions without a sternotomy (splitting the breastbone). Rather, the surgeon operates through small incisions with specialized instruments and camera scopes, which will result in less pain and trauma and quicker recovery for many patients. This approach will also allow the surgeon to have a better view of certain parts of the heart, and therefore a better and more comprehensive operation. Numerous publications have been published and data has shown patients who underwent MIS procedures have a faster recovery time, shorter hospital stay, lower infection rate, less surgical pain and less blood loss. Surgeons use the smallest incision to provide the safest and most successful surgery. Currently, Dr. Allen Cheng is the only surgeon at Oklahoma Heart Institute who conducts MIS surgery (as of September 2017).

Benefits of MIS surgery:

  • No breast bone splitting (no sternotomy associated morbidity) 
  • Less pain with reduced trauma 
  • Smaller incision 
  • Shorter recovery time – return to normal activities quicker 
  • Shorter length of hospital stay 
  • Lower wound infection rate due to smaller incision 
  • Lower risk of pneumonia (ambulate earlier, cough better with less pain) 
  • Less blood loss/decreased blood transfusion requirement 
  • Better and direct visualization of valves for better repair and replacement (better visualization than standard open heart surgery)

Minimally invasive cardiac valve surgery (MIVS) is a procedure performed for repairing or replacing heart valves through a small incision under direct vision. The procedure is performed through a right lateral (mitral, tricuspid, PFO, ASD, MAZE) or right anterior (aorta) mini-thoracotomy. Specialized instruments are used for the procedure to improve visibility. Femoral vessel cannulations are used for cardiopulmonary bypass. Minimally invasive heart surgery may be performed to treat a variety of heart conditions including:

  • Mitral Valve Regurgitation and Stenosis (Mitral Valve Repair or Replacement)
  • Tricuspid Valve Regurgitation and Stenosis (Tricuspid Valve Repair and Replacement)
  • Aortic Valve Regurgitation and Stenosis (Aortic Valve Repair and Replacement)
  • Double Valvular Disease (Combined Mitral and Tricuspid Repair or Replacement)
  • Atrial Septal Defect and Patent Ductus Ovale (Surgical Closure)
  • Atrial Fibrillation (Biatrial Maze IV or Total Thoracoscopic Hybrid Maze with radiofrequency and cryoprecipitate)
  • Atrial Mxyoma (Resection)
  • Coronary Artery Disease (MICAB)
  • Congestive Heart Failure (MIS LVAD placement)

Dr. Cheng is a board-certified cardiac surgeon. He specializes in advanced heart failure, heart transplantation, left ventricular assist device, minimally invasive heart surgery, valve surgery, atrial fibrillation and extracorporeal membrane oxygenation. Dr. Cheng said, “Minimally invasive heart surgery should be offered as an option for all patients who need open heart surgery. This approach has multiple benefits for patients who require heart surgery including less pain, faster recovery rate, shorter hospital stay, less risk of bleeding and lower infection rate. I am glad we are offering it at Oklahoma Heart Institute. We will be the first and currently the only center in Tulsa who is offering these procedures (as of September 2017).”

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Allen Cheng, M.D.