25 Questions and Answers
Minimally invasive cardiac surgery (MICS) is a modern heart operation performed through a small incision of 4–6 cm, without fully cutting the sternum. The heart is accessed from the side of the chest. It is as effective as standard open surgery while causing less trauma. Blood loss, pain, and recovery time are all reduced.
The main advantages are: a small incision, less pain, less blood loss, reduced infection risk, and a better cosmetic result. Patients are typically discharged within 3–4 days. Since the sternum is not cut, no healing period for bone fusion is required — a significant benefit for young and working patients who lead active lives.
It is suitable for specific operations such as mitral valve repair, tricuspid valve repair, single-vessel bypass, and ASD repair. Success rates are high in patients with appropriate chest anatomy who have not previously undergone chest surgery. It may not be preferred for multi-vessel disease or severe heart failure.
Mitral and aortic valve replacements, ASD/VSD repairs, some single-vessel bypasses, cardiac tumour removal, and certain arrhythmia surgeries. The decision is based on angiographic and echocardiographic assessment.
A 4–6 cm incision is made on the side of the chest. Specialised camera systems magnify and project the heart onto a screen. The surgeon operates through this small opening using long, thin instruments. The heart-lung machine is connected via the groin artery if required.
In experienced teams, an average of 3–4 hours. Working through a small incision requires careful manipulation, so in some cases it may be slightly longer than a conventional operation.
The ICU stay is generally 12–24 hours. Patients are mobilised the next day, begin eating, and perform breathing exercises to improve lung capacity.
Pain is significantly reduced because the incision is small. Since the sternum is not cut, coughing, laughing, and deep breathing are easy. Patient comfort is high with modern pain management protocols.
In most patients, no. Blood loss is minimal, which is a major advantage for patients who prefer bloodless surgery.
Most patients return home within 3–5 days; some can be discharged on the second day. Recovery is approximately half that of conventional open surgery.
The small wound is dressed regularly; showering is usually permitted from day 3 onwards. Light walking is encouraged. Any redness or discharge at the incision site should be reported to the doctor.
Yes. Instead of a large central scar, only a small, nearly invisible mark remains on the side of the chest. This provides a significant cosmetic advantage, particularly for female patients.
In correctly selected patients, yes. MICS performed by an experienced surgeon and team is as safe as conventional open surgery. Complication rates are low; however, for complex cases, open surgery remains the gold standard.
Multi-vessel disease, severe cardiac dysfunction, chest deformity, a history of previous heart surgery, and extensive calcification may preclude MICS.
In most cases yes, but it is connected via the groin artery rather than through the chest. This allows the heart to be temporarily stopped without opening the sternum. Some procedures can be performed on a beating heart.
General anaesthesia. The patient is unconscious throughout the operation and connected to a ventilator. The anaesthesia team monitors vital signs continuously.
Temporary rhythm changes such as atrial fibrillation can occur but usually resolve within a few days. The rate of permanent rhythm disturbance is very low.
Short walks can begin one week after discharge. Since the sternum is not cut, movement restrictions are minimal and rehabilitation progresses rapidly.
Usually within 2–3 weeks, once pain has fully subsided and the doctor has given clearance.
Desk workers can usually return in 2–3 weeks; those in physically demanding roles in 4–6 weeks. This is roughly half the recovery time of conventional open surgery.
In experienced centres, the mortality rate is below 1%. Complication rates are low and success rates are high.
No — on the contrary, the repair improves cardiac function. Exercise capacity typically increases noticeably after surgery.
95% of patients are satisfied with the cosmetic appearance. The scar blends with the skin tone within a few months and becomes barely noticeable.
Yes. Incisions placed below the breast provide both aesthetic and functional advantages. MICS is one of the most suitable techniques for female patients.
Yes. Repaired or replaced valves are as long-lasting as those in conventional surgery. Long-term outcomes and survival rates are comparable.
