Minimally Invasive Cardiac Surgery (MICS)

Heart surgery is a treatment for cardiac conditions that helps reduce disease severity and supports normal heart function. Surgical techniques have developed continuously over time. One such approach is minimally invasive cardiac surgery (MICS). With this method, a surgeon performs the operation without dividing the breastbone (non-median sternotomy). The incisions are small, meaning patients experience less pain compared to traditional surgery. This approach promotes an early recovery, lowers complications, and reduces mortality rates.

What Is Minimally Invasive Cardiac Surgery (MICS)?

Minimally Invasive Cardiac Surgery (MICS) is a surgical technique that does not require dividing the breastbone. It is performed by specialized medical practitioners utilizing specific instruments. Instead of a large 15-30 centimeter incision down the middle of the chest, a cardiothoracic surgeon will make a small opening on the side of the chest, under the breast, or between the ribs.

This helps reduce blood loss and tissue trauma, with an incision size of about 3-5 centimeters. It lowers the severity of post-operative infections and causes less pain than traditional approaches. Patients benefit from shorter hospital stays and can resume their daily lives with quality sooner.

What Conditions Does MICS Treat?

This surgical approach can be applied to treat various heart conditions, including:

• Coronary artery disease
• Valvular heart disease (stenosis or regurgitation)
• Cardiac arrhythmias
• Congenital heart defects, such as Atrial Septal Defect (ASD)
• Cardiac tumors

Types of Minimally Invasive Heart Surgery

There are several types of minimally invasive heart surgery depending on the specific cardiac condition:

Minimally Invasive Cardiac Surgery Coronary Artery Bypass Grafting (MICS CABG)

Minimally Invasive Cardiac Surgery Coronary Artery Bypass Grafting (MICS CABG) is an alternative treatment for coronary artery disease. Using specialized instruments, surgeons make a small 7 to 10 centimeter incision between the ribs or under the left breast instead of opening the chest bone. This creates a bypass for narrowed or blocked coronary arteries, allowing blood to flow properly again. Click here

3D Endoscopic Valve Surgery

Totally 3D Endoscopic Valve Surgery is a contemporary approach for patients with valve regurgitation or stenosis, functioning as an option for minimally invasive heart valve surgery. It is particularly suitable for those with limitations for open surgery, such as older adults or those with complex comorbidities. Using a high-resolution endoscope with a 3D display system, surgeons can perform both repairs and replacements without dividing the breastbone. Click here

Who Is a Candidate for MICS?

• Patients with medical indications for the surgery.
• Patients who prefer to avoid a median sternotomy.
• Older adults aim to lower the risks associated with major surgery.
• Patients with valve conditions or localized heart issues accessible via small incisions.
• Patients without complex comorbidities can undergo MICS heart surgery. However, individuals with severe chronic obstructive pulmonary disease (COPD) or chest deformities must be evaluated carefully.

Any patient in Thailand seeking this treatment must undergo a thorough evaluation by a cardiothoracic surgeon in Thailand who specializes in these specific procedures.

Advantages of MICS Compared to Open Heart Surgery

Post-Operative Care for MICS

• Attend follow-up appointments to monitor heart health.
• Take medications as prescribed by your doctor.
• Consume a heart-healthy diet.
• Exercise regularly.
• Manage stress appropriately.
• Refrain from smoking and consuming alcohol.

Why Choose Bangkok Heart Hospital for MICS?

• The first private hospital dedicated to cardiac care in Thailand.

• A group of surgeons with experience in over 400 MICS cases.
• Well-equipped diagnostic tools, surgical instruments, and operating rooms.
• Assessment, planning, and design of surgical treatments by specialized cardiac physicians.
• Standards and clinical outcomes recognized internationally.

Minimally invasive cardiac surgery (MICS) is an updated alternative that yields favorable outcomes for patients, reduces the recovery period, and lowers the risk of complications compared to open surgery.

Hospital Specializing in Minimally Invasive Cardiac Surgery (MICS)

The Cardiothoracic Surgery Center at Bangkok Heart Hospital features specialized physicians experienced in treatments ranging from MICS heart surgery and open-chest approaches to catheter-based and non-surgical options. Working collaboratively, these practitioners utilize fully equipped medical facilities to provide attentive care for every generation, helping patients regain their quality of life.

If you or your loved ones are facing a heart condition, do not wait until the heart stops beating. The MICS procedure might be the right option for you.

Doctors Specializing in Minimally Invasive Cardiac Surgery (MICS)

• Dr. Nuttapon Arayawudhikul, a cardiothoracic surgeon in Thailand, specializing in minimally invasive bypass surgery (MICS CABG) at Bangkok Heart Hospital. 
• Dr. Paradorn Jetwanna, a cardiothoracic surgeon in Thailand, specializing in minimally invasive heart valve surgery at Bangkok Heart Hospital.
• Dr. Permyos Ruengsakulrach, a cardiothoracic surgeon in Thailand, specializing in MICS CABG, minimally invasive valve surgery, and off-pump coronary artery bypass at Bangkok Heart Hospital.

Summary

Minimally invasive heart surgery is an option for treating specific cardiac conditions, such as coronary artery disease and valvular heart disease. For patients with medical indications who are evaluated as suitable candidates, the procedure involves a small incision on the side of the chest or under the breast without cutting the chest bone. This helps reduce tissue and blood vessel trauma, lowers post-operative pain, and supports a shorter recovery compared to open surgery. Choosing the surgical approach depends on the type of disease, physical condition, and assessment by specialized practitioners.

Frequently Asked Questions

1. How Long Is the Recovery Period?

Generally, patients stay in the hospital for about 1 week and recover in a shorter time compared to open surgery. They can begin light daily activities sooner. This depends on the specific surgery, physical condition, and physician evaluation.

2. What Is the Size and Location of the Incision?

The size depends on the surgery type. Endoscopic valve surgery incisions are about 3 to 5 centimeters, while a minimally invasive bypass surgery (MICS CABG) requires about 7 to 10 centimeters. Incisions are located on the side of the chest or under the breast, avoiding a visible scar in the middle of the chest like traditional methods.

3. Can Older Adults Undergo This Surgery?

Some older adults can receive this treatment if they pass an assessment by their doctors, who will evaluate overall health, comorbidities, and the appropriateness of the procedure for the individual.

4. If a Patient Has Multiple Underlying Conditions, Is This Surgery Possible?

Patients with conditions like diabetes, high blood pressure, or kidney disease might be eligible if assessed and approved by their physicians. However, individuals with severe chronic obstructive pulmonary disease or chest wall deformities might not be suitable candidates. Doctors will determine the appropriate treatment plan for each person.

5. Will the Condition Be Completely Resolved, and Will the Patient Return to Normal?

This procedure yields outcomes comparable to standard surgery in appropriate candidates. The majority of patients can recover and return to daily life or activities close to normal. However, treatment results depend on disease severity, comorbidities, the surgical process, and continuous health care afterward.