Guide to Heart Surgery Approaches

How is Heart Surgery Performed?

For decades, cardiac surgery was performed as an open-heart procedure, meaning that surgeons accessed the heart by making a large incision down the middle of the chest. In many cases, this is still the best way to perform heart surgery, but over the years, new techniques have been developed to provide safe and effective alternatives.

What is Open-Heart Surgery?

In open-heart surgery (or just “open surgery”), an incision is made through the breastbone (sternum), which is then spread apart. This is called a full or median sternotomy. After the operation is complete, the breastbone is closed with stainless steel wires and the skin is sutured closed. The stretching of the muscles, bones and ligaments during surgery usually results in some pain and discomfort following the operation; however, the breastbone will heal back to full strength.

What is Minimally Invasive Heart Surgery?

In minimally-invasive heart surgery, special surgical instruments (including high-tech cameras), are inserted through tiny incisions in the chest or rib cage. The number and location of incisions will depend on the specific disease process and patient anatomy. People who qualify for minimally invasive options typically have faster recovery, reduced risk of infection, and a better cosmetic outcome.

What is Robotic Heart Surgery?

Robotic heart surgery is a form of minimally invasive surgery. In robotic heart surgery, a cardiac surgeon directs the movements of a machine designed to make highly precise movements.  The robot is a surgical tool, and it is controlled entirely by the surgeon. Robotic surgery may be used for the treatment of coronary artery disease, atrial septal defects, mitral valve disease, removal of cardiac tumors, and the correction of abnormal heart rhythms.

What are Percutaneous Heart Procedures?

Percutaneous – also know as interventional - procedures are performed by inserting a tiny tube called a catheter into a vein or artery in the leg or arm.  The catheter tube is then threaded into the heart. Tools and instruments can then be passed through the tube to the site of the problem. Once in place, the doctor can open blocked vessels, install stents to prevent new blockages, control cardiac arrhythmias, close heart defects, and even repair or replace damaged heart valves. Percutaneous heart procedures may be performed by cardiac surgeons or by interventional cardiologists.

What is Hybrid Cardiac Surgery?

Hybrid cardiac surgery combines cardiac surgery with an interventional (catheter-based) approach. Hybrid procedures facilitate minimally invasive approaches to surgery in lieu of a traditional chest incision (sternotomy). In high-risk patients and patients undergoing repeat operations, risky surgical procedures may be converted to a less complex surgery combined with an interventional procedure. Using the surgical robot with these types of procedures results in very small incisions, less pain, quicker recovery times, and a high level of patient satisfaction compared to traditional surgical approaches.

If I Need Heart Surgery, What Are My Next Steps?

If you think or have been told you need heart surgery, your next step should be to get an evaluation or second opinion from a cardiac surgeon. Our surgeons can help you decide if surgery is truly necessary, and if so, which type of approach makes the most sense for you and your particular condition. 

To get started, call (212) 305-2633 or use our appointment request form.

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