Heart Surgery with Small Incision Method

Heart Surgery with Small Incision Method

The “minimally invasive”, that is, small incision method, which has been used in heart surgeries for a while, aims to restore health by giving the least damage to the patient. Heart surgeries with small incision provide important advantages such as shorter recovery time for the patient and less risk of complications.

Heart Surgery with Small Incision Method

In heart surgeries performed with classical methods, the patient’s bone, which is called the “sternum”, is completely opened; In this method, which can also be used in bypass surgeries as well as heart valve surgeries, the patient can regain his/her health with a 6-7 cm incision made under the armpit.

What are Heart Surgeries Performed with Small Incision Method?

Small incision surgeries can be performed successfully especially in the repair and replacement of heart valve surgeries, in coronary artery surgery, also in closing some heart holes and removing intracardiac tumors.

Small Incision Bypass Surgery

In small incision bypass surgery, the heart is reached without opening the sternum with an incision of approximately 7-8 cm under the left breast, and bypass surgery is performed on the beating heart, sometimes by stopping the heart.

Heart Valve Surgery with Small Incision Method

In this method, we reach the heart between the ribs with a small incision (between 5-7 cm) made under the breast on the right side of the chest, without cutting the sternum. We connect our patient to the heart-lung machine by means of a small incision (2-3 cm) made in the right groin and cannulas placed in the inguinal artery and vein of the patient. With special surgical instruments developed for this method, we can stop the heart, repair or replace the mitral valve by opening the heart cavity where the mitral valve is located.

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Heart Hole and Tumor Surgery with Small Incision Method

Closed heart surgeries are performed through small incisions. The sternum is not cut, the incisions made between the ribs are used.

Is Heart Surgery with Small Incision Suitable for Every Patient?

The priority is always patient’s health. Yes, small incision heart surgeries have many advantages for the patient, but the surgery is more difficult than the standard method. The priority is that the surgery to be performed is complete and perfect. Therefore, patients who will undergo heart surgery with a small incision method should be well evaluated before surgery in terms of their suitability for the method.

The following factors should be considered before deciding on the small incision method:

  • Anatomy of the patient
  • Surgery required to be performed
  • Whether the patient has lung disease and patient’s lung capacity
  • If the inguinal artery is to be used, its structure

These are the first factors to be considered.

Advantages of Small Incision Method in Heart Surgery

In heart surgeries performed with small incision method, the patient can be discharged in as short as 3 days. Especially in elderly patients, it is preferred because it is a method that causes less damage to the bone. In addition, aesthetically pleasing results can be obtained, especially in women. Less pain after the surgery, less damage to the bone, and the fact that the patient can move more easily after the surgery are other reasons for preference for the small incision method.

Minimally invasive cardiac surgery finds an important and dominant place for cardiovascular surgery. Surgical procedures with smaller incisions also have positive effects on the postoperative period for the patient.

What are the Advantages of Heart Surgery with Small Incision Method?

  • The patient feels that his/her body integrity has been lost in surgeries performed by completely cutting the sternum, which prolongs the psychological recovery period. In surgeries performed with small incisions, the recovery time is accelerated before the patient has this feeling.
  • In these surgeries, which are performed in a very small area compared to the standard incision, the integrity of the chest wall is preserved since the bone in the anterior chest wall called the sternum is not cut. This causes respiratory system problems, which are the most common problems after surgery, to be seen much less frequently.
  • The amount of bleeding during and after the surgery is very low, and the patient can be discharged without the need for blood transfusion in most surgeries.
  • Depending on the type of surgery, the pain is much less in these surgeries, which are performed with 6-7 cm incisions made under the right or left breast, sometimes under the collarbone, and sometimes with less opening of the breastbone.
  • As a result of all these, the length of stay in intensive care and hospital stays is very short compared to standard surgeries. The intensive care period lasts for one day and the service stay for 3 or 4 days.
  • In standard surgeries in which the sternum is cut, the time of recovery of the bone is approximately 2 months, and during this period, the patient should not turn around while lying down, should not raise his/her arms above the head level, should avoid activities such as driving a car and carrying any weight in his/her hands. None of these problems are encountered in surgeries performed with small incisions. After the operation, the patient can lie down as he/she wishes from the moment the drains are removed, and can easily do everything he/she did before the operation, such as driving, swimming, cycling, carrying a load, as soon as he/she feels well.
  • Surgery in which the sternum is opened is cosmetically very distressing. Especially in young patients, living with a large surgical scar in front of the chest can create a psychological problem. Although the length of the incision varies between 6-7 cm in operations performed with incisions under the armpit or under the breast, no surgical scar is seen unless the arms are raised. The operation scar shows a very successful recovery, and the patient continues his/her life with an incision scar that is not very obvious about 1 year after the operation.

Assoc. Prof. Dr. Mazlum ŞAHİN