What is keyhole heart surgery? Why would patients undergo keyhole surgery when conventional treatments exist? What advantages does keyhole heart surgery bring to patients? These are certain queries that crop up in the minds of patients suffering from heart ailments. Kottayam-based renowned heart surgeon Dr. Rajesh Ramankutty, who is expert in minimal access cardiac surgery, provides the answers:
Keyhole Heart Surgery is an advanced type of cardiac surgery technically called Minimal Access Cardiac Surgery (MICS). Unlike conventional heart surgery, it doesn’t need a sternotomy, where in the bone in the front of your chest cavity needs to be opened. Keyhole Heart Surgery can be performed through surgical wounds created on either of the sides of the chest (thoracotomy) or even through the centre of the chest (ministernotomy), sometimes, using 4-5 cm incisions.
Keyhole /MICS procedures have many advantages to their credit. It needs to be noted that small surgical wounds make one’s surgical experience better. Also, the procedure brings significantly less pain experience compared to the conventional procedures. The need for blood and blood product transfusion are reduced considerably. Further, fewer days of hospital stay, and early resumption of the routine; excellent cosmetic outcome; and very less wound-related complications are the advantages that Keyhole Heart Surgery offers.
Keyhole Heart Surgery or MICS procedures are performed for a broad spectrum of diseases. First, the commonest and the leading killer disease which affects either one, two or all three of the blood vessels within the heart musculature, is the coronary artery disease. In around 20-25% of such patients, bypass procedure is the treatment of choice. The same procedure which was performed all along with the open technique, can be done with the same precision and no less effect on its long term outcome, using the keyhole strategy by experts in this field.
The second group of conditions are those that affect the valves within our heart, which can either shrink or leak, causing impediment to the natural path of blood flow. Such valves were traditionally replaced after removing one’s own valve with a prosthesis. Such diseased valves can be made as functional as their pre diseased status by repairing them through small incisions. This alleviates the need for anticoagulant medications with narrow safety margin. Interestingly, valves can be replaced as well through keyhole approach.
There is also another spectrum of disease conditions that affect our heart since birth. Commonly addressed as the ‘hole in the heart’, these conditions allow admixture of oxygenated and deoxygenated blood inside our heart. Some of these conditions, like ASD (atrial septa defect) can also be repaired through the keyhole approach.
Lastly, some of the rare yet dangerous conditions are the tumours that arise inside the heart which can be removed safely via keyhole approach.
Keyhole Heart Surgery is undertaken with added precision. Patients who come in for Keyhole Heart Surgery are managed by experts comprising cardiovascular and thoracic surgeons, cardiologists, cardiac anaesthetists, expert nursing team with the calibre to manage these patients. Support team includes perfusion technologists, certified echo technicians, physiotherapists and the lab staff.
Patients are assessed for their surgical fitness with tests such as, blood panel, urine screen, serum screen, X-ray of chest, imaging of abdominal viscera and chest, pulmonary function test, and assessment of the carotid and peripheral arteries. Once the surgery team decides on the procedure, the patients undergo stabilisation of their existing medical conditions before their in-house admission, a day prior to the surgery. The immediate post-operative period is spent in the ICU and the rest in the ward. The average ICU stay on average is 1-2days and the total hospital stay is on average 4-5days. Patients spring back to their routine within a fortnight and will be able to even undertake air travel within this time frame. In case you have any doubt or query related to Keyhole Heart Surgery, call 9947095596 anytime between 9 am and 7 pm.
