How to Know the Latest Techniques in Open-Heart Surgery

Whereas standard open heart surgery involves an 8- to 10-inch incision through the length of the breastbone, newer techniques are less invasive and may only require a 2- to 4-inch incision. Minimally invasive techniques can also be used to harvest the leg veins used to create bypasses. Before getting any surgery done, find out about the latest techniques available and see if they sound right for your condition.

Instructions

Difficulty: Easy

1. Do as much research as you can about new techniques available for open-heart surgery. Look online and at your local library. Talk to someone who recently had open-heart surgery. Ask your cardiologist about the latest techniques.
2. For patients with limited blockages, a minimally invasive coronary artery bypass surgery called OPCAB (off pump coronary artery bypass) can now be done on a beating heart. A cardiopulmonary bypass and heart-lung machine are not required. Studies show a reduction in bleeding complications, post-operative intubation time, time in intensive care, overall hospital stay, morbidity and duration of ventilatory support.
3. Another new technique called MIDCAB (minimally invasive direct coronary artery bypass) is also performed on a beating heart and uses a small 4-inch incision. This procedure is only designed to bypass one or two coronary arteries. Advantages over traditional bypass surgery include: shorter procedure (2 to 3 hours instead of 3 to 6); reduced recovery time (from months to days or weeks); reduced need for blood transfusions, if any; less pain and discomfort; and up to 40% cost savings.
4. Minimally invasive valve surgery does require that the heart stop beating. A new approach to stop the heart beat uses a catheter placed through an artery in the leg and into the aorta. A balloon at the tip expands and blocks the flow through the aorta to stop the heart beat.
   
5. Robotic surgery uses even smaller incisions and pencil-thin instruments. The surgeon sits at a console with a video screen and guides robotic arms to operate the instruments.

Tips & Warnings

• The safety of OPCAB and MIDCAB is still in question, since these procedures are recent and long-term results are not known. Be sure your surgeon is experienced and comfortable with any procedure you choose.