In minimally invasive heart surgery, heart (cardiac) surgeons perform heart surgery through small incisions in the right side of your chest, as an alternative to open heart surgery. Surgeons operate between the ribs and don't split the breastbone (sternotomy), which results in less pain and a quicker recovery for most people. In minimally invasive surgery, your heart surgeon has a better view of some parts of your heart than in open heart surgery. As in open surgery, minimally invasive heart surgery requires stopping your heart temporarily and diverting blood flow from your heart using a heart-lung machine.

Surgeons perform many minimally invasive heart surgeries, including:

Your doctor will work with you to determine whether minimally invasive heart surgery is an option. If you've had prior heart surgery or heart disease, you generally aren't a candidate for minimally invasive heart surgery. Your doctor also may perform tests and review your medical history to determine whether you're a candidate for minimally invasive heart surgery. Mayo Clinic offers robot-assisted surgery or thoracoscopic minimally invasive heart surgery.

Advantages

Minimally invasive heart surgery isn't an option for everyone, but it offers many advantages in those for whom it's appropriate.

Advantages may include:

  • Less blood loss
  • Lower risk of infection
  • Reduced trauma and pain
  • Shorter time in the hospital, faster recovery and quicker return to normal activities
  • Smaller, less noticeable scars

Risks

In people for whom minimally invasive heart surgery is appropriate, risks and complications are rare. You may experience these complications, which also may occur in other surgeries:

  • Bleeding
  • Stroke
  • Wound infection

Types

Mayo Clinic heart surgeons work with an experienced surgical team to perform minimally invasive heart surgery, including robot-assisted heart surgery and thoracoscopic heart surgery. In both types of procedures, surgeons reach your heart through small incisions between the ribs of your chest.

  • Robot-assisted heart surgery. In robot-assisted heart surgery, the exact maneuvers performed in traditional open chest operation are duplicated by the surgeon using robotic arms, rather than his or her hands. During this procedure, your surgeon works at a remote console and views your heart in a magnified high-definition 3-D view on a video monitor.

    From the remote console, your surgeon's hand movements are translated precisely to the robotic arms at the operating table, which move similarly to the human wrist. A second surgeon and surgical team assists at the operating table, changing surgical instruments attached to the robotic arms.

  • Thoracoscopic surgery. In thoracoscopic surgery (sometimes referred to as a mini-thoracotomy), your surgeon inserts a long, thin tube (thoracoscope) containing a tiny high-definition video camera into a small incision in your chest. Your surgeon repairs your heart using long instruments inserted through small incisions between your ribs.

After performing a physical examination and reviewing your clinical records, echocardiogram, and CT scan, Mayo Clinic doctors will determine whether a conventional open operation or minimally invasive operation is best for you.

  • Experience. Mayo Clinic heart surgeons perform more than 200 minimally invasive heart surgeries each year, including robot-assisted heart surgery and thoracoscopic heart surgery.
  • Specialized teamwork. At Mayo Clinic, a team of doctors with training in heart disease (cardiologists), heart (cardiac) surgeons and other specialists with training in minimally invasive heart surgery work closely to provide integrated, coordinated care. The team works with you to ensure a full, smooth recovery after surgery.
  • Cutting-edge medicine. Mayo Clinic heart surgeons and researchers actively study potential new techniques, advanced technology and new developments for minimally invasive heart surgery in clinical and laboratory research.
  • Pediatric expertise. Mayo Clinic in Minnesota is one of the few medical centers in the United States experienced in performing minimally invasive heart surgery in children. Youth needing hospitalization receive care at Mayo Eugenio Litta Children's Hospital at Mayo Clinic in Minnesota.

Mayo Clinic in Rochester, Minn., is ranked among the Best Hospitals for heart and heart surgery by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for heart and heart surgery.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Experienced Mayo specialists in cardiovascular and thoracic surgery treat many conditions using minimally invasive heart surgery at Mayo Clinic in Arizona.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in cardiothoracic surgery and cardiovascular diseases treat many conditions using minimally invasive heart surgery at Mayo Clinic in Florida. The Cardiopulmonary Rehabilitation Program helps people improve their quality of life and health after surgery.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in cardiovascular surgery perform roboti-assisted and thoracoscopic minimally invasive heart surgery at Mayo Clinic in Minnesota. Surgeons perform more than 200 minimally invasive heart surgeries each year.

If needed, doctors from the Mayo Heart Valve Disease Clinic at Mayo Clinic in Minnesota evaluate people who have heart valve disease before surgery. Mayo Clinic doctors work with heart rhythm specialists (electrophysiologists), heart surgeons and other specialists to coordinate your care. Mayo Clinic is one of the largest and most experienced medical centers in the United States for heart valve disease treatment.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Minnesota, specialists in pediatric cardiology and cardiovascular surgery treat a variety of heart conditions in children who may need minimally invasive heart surgery. Mayo Clinic in Minnesota is one of the few medical centers in the United States experienced in performing minimally invasive heart surgery in children. Youth needing hospitalization receive care at Mayo Eugenio Litta Children's Hospital at Mayo Clinic in Minnesota.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic cardiac surgeons and researchers actively study potential new techniques, advanced technology and new developments for minimally invasive heart surgery in clinical and laboratory research. Learn more on the research website.

See a Mayo Clinic list of publications at PubMed, a service of the National Library of Medicine.

Rakesh M. Suri, M.D., D.Phil. Mar. 07, 2014