Minimally Invasive Cardiac Surgery (MICS) is a type of heart surgery that is performed through a succession of small incisions rather than the traditional open-heart surgery procedure that involves a median sternotomy. MICS is a beating-heart multi-vessel surgery performed under direct view through an aterolateral mini-thoracotomy.
Surgeons and patients alike prefer minimally invasive cardiac surgery because it results in less post-operative discomfort, faster healing times, and a lower chance of infection or complications. This method allows patients who were previously deemed too risky for standard surgery owing to age or medical history to undergo heart surgery. Patients with Coronary Artery Disease (CAD), Triple Vessel Disease with middle to big posterior descending artery (PDA), or past unsuccessful stenting may be referred for this surgery.
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MICS is conducted by a 5–7 cm long window incision in the 4th intercostal region (ICS). In some situations, a thoractomy in the 5th ICS may be required instead. To improve vision and access, a soft tissue refractor is employed.
To allow surgical tools to pass through, two access incisions are made at the 6th intercostal gap and xphoid process
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Above: During coronary artery bypass surgery, minimally invasive tools position and stabilise the heart, avoiding the necessity for a sternotomy (incision of the sternum).
Above: During coronary artery bypass surgery, minimally invasive tools position and stabilise the heart, avoiding the necessity for a sternotomy (incision of the sternum).
After MICS surgery
Patients who undergo minimally invasive cardiac surgery recover faster and have fewer difficulties than those who undergo open-heart surgery. Within a few weeks of their operation, most patients should be able to resume their normal activities. Patients are given a pain pump and drains following surgery, which are removed after one day. To recuperate rapidly, patients are encouraged to move around as much as possible after their operation. Patients do not require any additional post-operative care once they have been discharged from the hospital.
Minimally invasive cardiac surgery techniques are a safe and widely used technique for a variety of complex cardiac surgeries, such as single or multiple heart valve procedures, bypass surgery, and congenital heart repairs.
For the following operations, minimally invasive cardiac surgery has been used as an alternative to standard surgery:
• Repair and replacement of the mitral valve
• Replacement of the aortic valve
• Repair and replacement of atrial septal abnormalities
• Coronary artery bypass graft
Benefits of MICS
The requirement for a median sternotomy is eliminated, which lessens the trauma and discomfort associated with open-chest surgery and enhances patients’ quality of life. Reduced post-operative discomfort allows patients to begin a much faster recovery process after minimally invasive cardiac surgery in the hospital. Most patients are able to walk more effortlessly and are more involved in their personal care. Furthermore, this method reduces the chance of consequences including bleeding and infection.
Cosmetic scarring is greatly improved with minimally invasive cardiac surgery. Patients are left with minor markings on the side of the ribs rather than a visible 10-inch scar down the middle of the chest. Because it is hidden beneath the breast, this scar is often unnoticed by women.
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