Department of Cardio Thoracic

 

The Key to Successful Keyhole Bypass Surgery
 Even major surgeries like Cardiac Bypass can be done safely through,Keyhole Surgery says Dr. V.V. Bashi

The common problems requiring surgery for the heart are: Coronary artery disease, diseases affecting the valves of the heart, diseases present from birth like holes in the heart or blocks in the valves, mixing of blood inside the heart.

Normal Method of Surgery
The chest is opened through a cut in the midline. The heart is stopped along with the lungs and the heart lung machine is used to sustain the normal function of the rest of the body. Blood is then cooled. Stopping of the heart is done by injecting cardioplegia which paralyses the heart. Once the operation is over, the heart lung machine is stopped after the heart takes over its function.

Problems with the use of Heart Lung Machine

  • Excess bleeding – requiring blood transfusion

  • Brain problems like stroke

  • Kidney dysfunction

  • Increased chances of infection

  • Increased hospital stay

  • Increased cost

Minimally Invasive Cardiac Surgery
Beating Heart Surgery: In this the heart lung machine is not used to do the operation. The commonest operation done using this technique, is bypass surgery.

Advantages of Beating Heart Surgery

  • No requirement of blood transfusion

  • Upto 30% savings in cost over conventional bypass surgery

  • Minimal stay in the ICU and in the hospital

  • Minimized chances of infection

  • Faster rate of recovery

Minimally Invasive Valve Surgery
In this procedure, small cuts are made in the chest to see the heart and do the operation. Valve replacement is done after stopping the heart.

Robotic Surgery
With the use of robots, bypass surgery can be done with incision as small as 3”. Removal of veins and arteries can be done through endoscopy.

In our institution minimal access surgeries like Aortic valve replacement/Mitral valve replacement through mini sternotomy and ASD closure through posterolateral thoracotomy are performed with good results. Endoscopic conduit harvesting is done in selected cases. Almost 95% of the CABG’s are done without using the heart lung machine with a 99.5% success rate.