MINIMALLY INVASIVE OPEN HEART SURGERY AN EXPERIENCE AT NICVD

Abstract

Objective: This study was done to show that open heart surgical procedures can be done through a small
sternal incision. Design: This was a single center prospective study. Place and Duration of study: Department
of cardiac surgery, National Institute of Cardiovascular Diseases, Karachi. The study was completed in two
years i-e Jan 1998 to Dec 1999. Subjects and Methods: A total of 40 patients underwent open heart surgery
via minimally invasive approach through a lower median sternotomy. Of these 22 patients had ASD Closures,
8 underwent CABG Surgery and 10 patients had MVR procedure. The approach was via a small incision 8-1
0cm in length from xiphoid upwards and asymetrical lower median sternotomy upto the 2 nd 1. C. S.
deviated from midline on to the right side. Results: 22 patients had ASD Closure of these 21 patients had
secundum defects while 1 had sinus venosus defect. In IHD group 2 patients had single vessel disease and 6
patients had 2 vessel disease (LAD & RCA). 10 patient had MVR of these 5 patient had MR while 5 had
mixed lesions. These patients had less postoperative pain. Early mobilization was achieved. No incidence of
sternal dehiscence was noted. The scar was cosmetically much better than the conventional sternotomy scar
and was completely hidden under the shirt.
Conclusion: Open heart surgery is possible through a minimally invasive procedure. The advantages of the
procedure are less trauma, less postoperative pain, reduced risk of infection. Patient recovery is quick and
excellent cosmetic result.