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What Is Minimal Invasive Heart Surgery
What Is minimal invasive cardiac Surgery
Minimally invasive heart surgery (also called keyhole surgery) is performed through small incisions, sometimes using specialized surgical instruments. The incision used for minimally invasive heart surgery is about 2 to 3 inches instead of the 6- to 8-inch incision required for traditional surgery.
Benefits of Minimally Invasive Surgical Techniques
The benefits of minimally invasive heart surgery techniques include:
• Small incisions
• Small scars
• Less pain
• Shorter hospital stay after surgery: The average stay is 3 to 5 days after minimally invasive surgery, while the average stay after traditional heart surgery is 7 to 10 days
• Low risk of infection
• Low risk of bleeding and blood transfusion
• Shorter recovery time and faster return to normal activities/work: The average recovery time after minimally invasive surgery is 1 to 4 weeks, while the average recovery time after traditional heart surgery is 6 to 8 weeks.
• Division of the breastbone is not needed .
Important Note: Not everyone is a candidate for these surgical techniques.
What are the Types of Minimally Invasive Heart Surgeries
Minimally Invasive Valve surgeries, including valve repairs and valve replacements, are the most common type of minimally invasive surgery.

Minimally invasive coronary artery bypass graft surgery is an option for some patients who require a left internal mammary artery bypass graft to the left anterior descending artery and with the advancement of instrumentation it can be done in multivessel disease also.
Saphenous (leg) vein harvest also may be performed using small incisions.


Minimally Invasive congenital heart surgeries like closure of Atrial septal defects and ventrcular septal defects.

Can all heart surgeries be performed by minimal invasive techniques
There may be a trend to perform more cases with minimally invasive techniques, but there will always be certain cases that will require traditional and conventional incision..

Who Is a Candidate for Minimally Invasive Cardiac Surgery
The surgeon will review the results of the diagnostic tests before scheduled surgery to determine if particular patient is a candidate for a minimally invasive technique. The surgical team will carefully compare the advantages and disadvantages of these techniques with those of traditional surgery. The type of treatment recommended for a particular patient depends on several factors, including the type and severity of heart disease, age, medical history and lifestyle.
What is the Recovery time after the minimal invasive heart surgery
Patients who have minimally invasive cardiac surgery may be able to go home 2 to 5 days after surgery. The healthcare team will follow the progress and helps in recovery as quickly as possible.
The healthcare team will provide specific instructions for the recovery and return to work, including guidelines for activity, driving, incision care and diet.
When Can I go back to work after this surgery
In general, you may be able to return to work (if you have a sedentary job), resume driving and participate in most non-strenuous activities within 1 to 4 weeks after traditional minimally invasive heart surgery. You can resume heavy lifting and other more strenuous activities within 5 to 8 weeks after surgery. Your healthcare team will provide specific guidelines based on your rate of recovery.
Recovery for all patients after heart surgery
To maintain the cardiovascular health after surgery, we strongly encourage the patients to make lifestyle changes and take the medications as prescribed. Heart-healthy lifestyle changes that are important to recovery include:
• Quitting smoking
• Treating high cholesterol
• Managing high blood pressure and diabetes
• Exercising regularly
• Maintaining a healthy weight
• Eating a heart-healthy diet
• Participating in a cardiac rehabilitation program, as recommended
• Following up with your doctor for regular visits

What are the disadvantages of minimally invasive surgery?
Being a new technology, there may be an associated learning curve with the Surgeon performing the case. Cost of operation is also little more compared to the tradional surgery but the benifits are more.

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Rare blood group patient goes for auto transfusion
HYDERABAD: A Srinivas, 44, underwent a heart valve replacement surgery at a city hospital. Like all other patients undergoing surgery, he too needed blood. But being O-ve (Bombay phenotype), a very rare blood group, he could not get any donor after a relentless search. Left without any option, doctors put him on iron supplements for seven days following which they withdrew two units of blood (medically called auto transfusion), and performed the surgery.

People like Srinivas are universal donors but when it comes to receiving blood, they have to depend on O-ve (Bombay phenotype) donors only, specialists say. "Considering his heart condition, it was necessary to perform the surgery at the earliest. After exhausting all the options of getting blood from other sources, we decided to harvest blood drawn from the patient and use it for surgery," said Dr Amrendra Singh, cardiac surgeon, Kamineni hospital, L B Nagar, who performed the surgery along with his team. This was second such case in Dr Singh's 10-year career.

Srinivas underwent the surgery with doctors taking extra precaution to conserve the blood. His two units of precious blood were used for the operation and has been discharged from the hospital. According to specialists, O-ve blood group is rare and its Bombay phenotype subgroup is its very rare variant. It is found in four (persons) out of ten lakh population.

"People with this blood group should donate blood for emergency situations. While negative blood groups are always short in supply, it is worse when it comes to O-ve (Bombay phenotype). In emergency situations such as accidents, it can be life threatening," says a surgeon from Nizam's Institute of Medical Sciences. He added that auto transfusion is the only way for these patients but it works out only for elective surgeries and not emergencies.

Dr Ramesh Babu Byrapaneni, chief cardiologist and MD of Medwin hospital says that the hospital had done a similar case almost a decade ago. "We got a patient from the Jehovah's Witnesses (a quasi Christian Sect) which does not accept blood transfusion at all. For this patient, we had to go for auto transfusion," said Dr Ramesh. Further, Dr Ravi N Bathina, cardiologist at Care hospital added that it is a safe procedure and common in countries like US. Dr Ravi, who has worked in the US said that he did not come across such a case in his practice in India.

According to officials at NTR Blood Bank, it takes months and sometimes years to get this blood group. Last year, NTR blood bank could arrange four units of this blood group after much effort

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