Heart (cardiac) surgery has undergone a significant transformation over the past decades. In the past, coronary artery bypass grafting (CABG) and other cardiac procedures needed a full median sternotomy, which is a procedure to create access to your heart or other body parts that your breastbone protects. While effective, this full median sternotomy approach often involved substantial pain, longer hospital stays, and prolonged recovery periods.
Thankfully, today's medical advancements like MICS and MICAS are changing the way heart disease is treated. These are minimally invasive heart surgeries that involve making small cuts, called incisions, in the chest. Unlike traditional open-heart surgery, these techniques don't cut through the breastbone. Hence, MICAS and MICS involve less pain, often a shorter hospital stay, and a quicker recovery.
Let's understand them with a simple analogy:
Think of them like a “keyhole approach” instead of a “full door opening.” Rather than opening the entire front door of the chest to reach the heart, surgeons now use small, precise entry points—just enough to perform complex repairs inside safely and effectively. It’s the difference between renovating a house by breaking down whole walls versus carefully accessing only the exact spot that needs repair.
What is Minimally Invasive Cardiac Surgery (MICS)?
Minimally invasive cardiac (heart) surgery is an umbrella term used for heart procedures performed through one or more small cuts (incisions). Whereas open-heart surgeries usually use one long incision down the front of your chest.Because of the small incision, minimally invasive heart surgery offers the following benefits:
- Less blood loss and infection.
- No sternal splitting, meaning there is no need to cut or crack the breastbone.
- Less pain.
- Less time needing a breathing machine, known as a ventilator.
- Less time spent in the hospital.
- Faster recovery and quicker return to usual activities.
- Smaller scars.
Types of MICS Approaches
There are two main types of minimally invasive heart surgery approaches:| MICS Approach | Details |
| Thoracoscopic surgery | The surgeon makes one or more small incisions in the side of the chest. They operate using long, thin tools.
They insert a long tube with a video camera (known as a thoracoscope) via the incisions to view the heart. |
| Robotically assisted heart surgery | The surgeon makes one or more small incisions in the side of the chest. They guide robotic arms through the incisions.
The robot displays clear images of the heart, and the surgeon controls the robotic arms to perform the procedure with precision. |
Common MICS Procedures in Mumbai, India
Here are some of the common procedures that are done in a heart care center, like the Asian Heart Institute in Mumbai:- Minimally Invasive CABG (Coronary Artery Bypass Grafting)
- Valve Repair or Replacement
- Atrial Septal Defect (ASD) Closure
- Endoscopic Cardiac Surgery
- Transcatheter Aortic Valve Replacement (TAVR)
- Video-Assisted Thoracoscopic Surgery (VATS)
- Maze Procedure for Atrial Fibrillation
- Cardiac Tumor Removal
- Patent Foramen Ovale (PFO) Closure
- Ventricular Assist Device Placement
What is Minimally Invasive Coronary Artery Surgery (MICAS)?
"MICAS" specifically refers to minimally invasive procedure used for coronary artery bypass surgery (CABG). It is often known as minimally invasive bypass surgery or MICS CABG.Instead of opening the chest through a large incision, MICAS uses the following:
- Small incisions between the ribs.
- Endoscopic visualization (camera-assisted surgery).
- Specialized long surgical instruments.
- In some cases, robotic assistance.
MICAS vs Traditional Bypass Surgery
Explore this table to know the difference:| Feature | MICAS (Minimally Invasive Bypass) | Traditional CABG (Open‑Heart Bypass) |
| Incision | Small (3–6 cm, between the ribs) | Large midline chest incision (full sternotomy) |
| Bone cutting | No full sternum cut; chest wall remains mostly intact | The sternum is fully divided/cut |
| Post‑operative pain | Lower pain due to no bone healing | Higher pain due to sternal healing and a larger wound |
| Infection risk | Lower risk of sternal and wound infections | Higher risk of sternal wound and deep‑chest infections |
| Recovery time | Faster recovery (weeks); many resume routine in 2–3 weeks | Longer recovery (6–12 weeks or more, especially for lifting) |
| Hospital stay | Shorter stay (often 3–5 days) | Longer stay (typically 6–7 days or more) |
| Scarring | Minimal, small side‑chest scar; less visible | A prominent central chest scar running from upper to lower chest |
Benefits of MICS and MICAS
Because of their minimally invasive nature, these advanced cardiac surgery techniques offer the following benefits:- Faster recovery
- Less pain and trauma
- Lower risk of infection
- Shorter hospital stay
- Better cosmetic outcome, because of less noticeable scars
- Faster return to work and daily activities
Who is Eligible for MICAS/MICS?
Not every patient is suitable for minimally invasive heart surgery. Doctors at Asian Heart Institute evaluate several factors:Suitable Candidates
- Single- or double-vessel coronary artery disease
- Certain valve diseases
- Good lung and heart function
- Favorable chest anatomy
Not ideal for:
- Complex multivessel diffuse disease
- Severe heart failure
- Prior complicated chest surgeries
- Extensive calcification or adhesions
Is Minimally Invasive Heart Surgery Safe?
Yes. There is a risk of complications with any type of surgical procedure. However, minimally invasive surgeries often have lower complication rates than traditional open procedures.Here are some of the possible risks:
- Bleeding.
- Heart attack.
- Irregular heartbeats (arrhythmias).
- Infection.
- Stroke.
Recovery After MICAS
Most patients return to normal routines and desk jobs within 3 to 4 weeks. However, full recovery can take 6 to 8 weeks. Follow your doctor’s advice for faster and safer recovery.Conclusion
MICAS and MICS have replaced the need for large chest incisions with small, precise surgical access points. But that does not mean traditional open surgery becomes irrelevant, as they have their own advantages.In some cases, minimally invasive heart surgery is not suitable, so the doctor may recommend a traditional open-heart approach. All you need to do is make an informed decision with your doctor and follow their advice to achieve the best possible outcome for your heart health.
Looking for the best heart hospital near me in Mumbai, India, for minimally invasive heart surgery?
Connect with the expert team at Asian Heart Institute for specialized heart care and minimally invasive surgical expertise.
- Helpdesk: +91 22-66986666
- OPD: +91 22-66986536 / 6675
- Email: info@ahirc.com
FAQs
Q1: What is minimally invasive heart surgery used for?A: Doctors can use this technique for a variety of surgeries, such as:
- Atrial septal defect (ASD) closure.
- Atrioventricular canal defect surgery.
- Cardiac tumor removal.
- Valve repairs or replacements.
- Ventricular assist device placement.
- Coronary artery bypass surgery.
- Maze procedure for atrial fibrillation.
- Patent foramen ovale (PFO) closure.
A: It may depend on the complexity of the condition and various other factors. Minimally invasive heart surgery usually takes about 2 to 6 hours.
