Minimally Invasive Cardiac Surgery
Dr. Yugal Kishore Mishra
Nov 05, 2020
Some heart problems can be managed with lifestyle changes and medicines, whereas others such as heart blocks and defects in major blood vessels require surgery. This speciality of medicine is known as cardio-thoracic and vascular surgery (CTVS). CTVS is used to manage disorders associated with the heart, lungs, and chest. Cardiothoracic surgery majorly aids in the opening of the blocked coronary arteries, correcting heart rhythm problems, or repairing heart defects or weakened heart muscles. Vascular surgery, on the other hand, deals with blood vessel disorders, such as diseases of lymphatic vessels, veins, and arteries. It helps in repairing and managing a network of blood vessels. Vascular surgeries may also include rerouting of blood flow.
Founded on 16th October 2018, the CTVS is one of the significant surgery units in our hospital. This division has contributed over 560 successful surgeries covering a various spectrum of surgical treatment of vascular and heart disorders, from coronary artery bypass to aortic aneurysm repairs.
Manipal Hospital is the best hospital for cardiothoracic surgery in Delhi having highly experienced cardiothoracic surgeons in Delhi who follow an integrated team approach to offer diagnosis and treatment of the full spectrum vascular and heart disorders. The surgeons work together with cardiologists and other healthcare professionals to provide the most effective and advanced cardiac care.
Our unit is well-equipped with state-of-the-art facilities and offers advanced treatment options such as the minimally invasive approach to repair or replace heart valves.
We, at Manipal, offer comprehensive and high-quality cardiovascular care to provide life-changing heart and vascular disease treatments.
Besides, the Manipal CTVS unit is prepared with high-end equipment and state-of-the-art technology to offer treatment. We are also backed up by Critical care specialists and intensivists with treatment options such as IABP, ECMO, and CRRT.
Also known as percutaneous coronary intervention (PCI), angioplasty, is a procedure used to open coronary arteries (blood vessels supplying the heart) that are narrowed, clogged, or blocked due to atherosclerosis (fatty plaque formation). Angioplasty is performed to reduce chest pain caused by restricted blood flow and reduce damage to the heart from…
A left ventricular assist device (LVAD) is an implantable mechanical circulatory pump that helps the left ventricle to pump blood to the aorta and throughout the body.
TAVR is also called Transcatheter Aortic Valve Implantation (TAVI). TAVR is a minimally invasive procedure that involves placing or inserting a new valve inside the diseased or a damaged heart valve.
Bentall procedure is a cardiac procedure that was introduced by H Bentall and A De Bono in 1968. It is performed to repair or replace an aortic root, aortic valve, or ascending aortic root lesion.
Coronary heart disease or coronary artery disease is characterized by the build-up of a waxy substance called plaque inside the coronary arteries blocking the blood flow. Coronary artery bypass graft surgery/bypass surgery/heart bypass surgery is recommended in emergencies such as heart attack, to ease symptoms of coronary artery disease, including…
The human heart has 4 valves that are responsible for controlling blood flow through the heart. Valves can be damaged or affected by disease, in which case they will need to be repaired or replaced. Damaged valves can be repaired by the placement of a special ring, while artificial valves are used to replace valves that are damaged beyond repair. While…
Minimally invasive cardiac surgeries can be done in both children and adults.
There is no additional risk associated with minimally invasive cardiac surgeries. Just like open-heart surgeries, risks involve bleeding, stroke, infection, arrhythmia and death.
The main areas of CTVS are:
CTVS Adult Surgery
CTVS Pediatric surgery
Some common conditions that can be managed with CTVS are:
Coronary artery disease
Valves diseases of the aortic, mitral, tricuspid, and the pulmonic valve
Rheumatic heart disease
CTVS Adult Surgery
Some common surgeries include:
Coronary artery bypass surgery (CABG): It is one of the most common operations performed by this department. It is an open-heart surgery where an artery from your arm or chest wall or a vein from your leg is used to bypass a heart artery, which is blocked or narrowed by a fatty plaque.
Robotic CABG: It is a relatively new and less invasive procedure and used as an alternative to conventional CABG surgery. Here, the surgeon uses a robotic machine with a camera attached to its arm. The doctor can precisely control the arms of the machine using a computer console.
Minimally Invasive Direct Coronary Artery Bypass (MIDCAB): It further limits the invasiveness by using a smaller incision and operating on a beating heart. It is a challenging procedure, and Manipal surgeons are among a very few surgeons performing this procedure.
During this procedure, the operating team uses advanced equipment to re-establish blood flow to coronary arteries. It is done by bypassing the blocked blood vessel and stabilizing heart portions in an extremely organized environment.
Heart Valve Surgeries
Diseased or damaged heart valves cannot function normally. This, in turn, puts excess stress on the heart muscles. Here replacing and repairing the valves aids in regaining their normal functions.
Mitral Valve Replacement (MVR)
Double Valve Replacement (DVR)
Tricuspid valve repair/ Replacement
Transcatheter aortic valve implantation (TAVI)/ Transcatheter aortic valve repair (TAVR)
Due to calcification, the heart's aortic valve narrows and fails to open fully, interrupting oxygen-rich blood flow to the rest of the body. TAVR is a minimally invasive procedure just like angioplasty, which involves replacing a diseased valve with a mechanical one with the help of a catheter placed inside the aorta
Heart post-Aortic Valve Replacement (AVR) + Mitral Valve Replacement (MVR) + Mitral valve repair
In this surgery, a small metal tube or stent is placed in the narrow artery to open it. Before this procedure, the doctor will perform angioplasty to remove the plaque build-up.
Right atrial/left atrial Myxomas
Aortic Aneurysm Repair
Frozen Elephant Trunk and Aortic Arch replacement
Ascending aortic aneurysm repair with island graft + intra-aortic balloon pump (IABP)+ Echo
CTVS Pediatric surgery
Kids require more compassionate care as compared to adults. Our team of interventional cardiac surgeons and pediatric cardiologists are supported by other healthcare professionals.
This multidisciplinary team provides your kids with the highest quality and most effective care in cardiovascular disorders. Whenever possible, the team will select a clinically advanced and most invasive approach to prevent infection and lower the risk of complications.
Some of the common surgeries performed at our CTVS pediatric unit are:
Atrial septal defects
Surgical Treatment of Heart Failure: Heart failure can be treated by -
Coronary Artery Bypass Graft (CABG):
Coronary arteries narrow with the build-up of plaque and eventually block the oxygen-rich blood flow.
Healthy blood vessels or grafts from the chest, wrist, or arm are used to bypass the blocked arteries and restore normal blood flow
Valve surgery is performed to either replace the weakened value or repair the value by supporting it with a ring.
Left Ventricular Assist Device (LVAD):
Percutaneous Mitral Valve Repair (PMVR):
The abnormal reverse flow of blood from the left ventricle to the left atrium is called mitral valve regurgitation.
PMVR, also known as mitral clip procedure, is a minimally invasive procedure in which a mitral clip is implanted in the damaged value to prevent the reverse flow of blood.
Once the blood flow is restored, the replaced heart starts to function.
A patient with a heart transplant has a good chance of survival if appropriate follow-up care is practiced.
A cardiothoracic surgeon is a medical doctor who specializes in surgical procedures of the heart, lungs, esophagus, and other organs in the chest. This includes surgeons who can be called cardiac surgeons, cardiovascular surgeons, general thoracic surgeons, and congenital heart surgeons.
It is required by one who suffers from blocked or narrowed arteries, heart rhythm disorders, or weakened heart muscles, heart valve disease or congenital heart disease.
After the surgery at the best vascular surgery hospital in Dwarka, Delhi, you will be taken to an intensive care unit (ICU) where intensivists will monitor your breathing, blood pressure, alertness, and wound. The patient is usually extubated on the same day or the next day and tubes are removed on the 2nd day. The patient usually starts moving after 2 days and shifts to the ward on the 3rd day and is discharged on the 6th to the 7th day.
Precautions may differ for all procedures. However, some common precautions include:
Consuming softer foods. Your throat may be sore, and you may find it difficult to swallow for an initial 1-2 days.
Take all the medicines prescribed by your doctor, which may include painkillers and anti-platelet medications.
To limit swelling and pain, you may be advised to keep your head propped up on pillows while lying down.
Don't drive until your doctor advises you to.
Avoid strenuous activities for a few days, such as heavy exercise or lifting heavy objects, unless advised by your doctor.
Resume normal activities only after being suggested by your doctor.
Watch for symptoms such as headache or swelling in the neck, or pain or swelling at the site of the procedure. Consult your doctor in case you find such changes.
All in all, it is essential to follow your doctor's advice at the vascular surgery hospital in Dwarka, Delhi.
Usually, a minimally invasive cardiac surgery includes single or multiple very small incisions between your ribs. The surgeon at the top vascular surgery hospital in Dwarka, Delhi then inserts a high-definition endoscopic system with a tiny camera through the incision to have a better view of your heart. The camera helps to display an image of your heart on a monitor.
Its benefits include:
A small incision and thus less scar so cosmesis is good
Lower risk of infection
A shorter hospital stay
A shorter recovery time
A re-do surgery is performing a surgery on a patient who already underwent a heart operation in the past. While many patients may require this surgery, some common ones are:
Cardiovascular Thoracic Surgery can be both simple and complex, whatever be the procedure, Manipal Hospitals will be there with you every step of the way, helping you decide on the right treatment plan, providing the right post-operative care and recuperation assistance. Contact us to know more about the different cardiovascular thoracic surgery and book an appointment with one of our surgeons today