Floyd Memorial Is First in the Region to Offer Minimally Invasive Cardiac Bypass Surgery

March 12, 2010

Anyone who has undergone cardiac bypass surgery knows that recovery is lengthy and involves significant discomfort. Now, Floyd Memorial has introduced a minimally invasive procedure that helps speed recovery and lessen discomfort.

Until recently, the standard surgical treatment for people with severely blocked arteries was traditional coronary artery bypass grafting surgery, or CABG (also known as “open heart surgery”). It requires a long incision in the chest and necessitates the division and separation of the sternum, or breastbone, so that the surgeon can reach the heart. It is extremely invasive and involves a lengthy recovery period.

These are just a few of the reasons a new, minimally invasive option in cardiac bypass surgery has created such excitement. A. David Slater, MD, a specialist in adult cardiac surgery and professor of surgery at the University of Louisville, explains more about this revolutionary procedure, available in the Louisville/Southern Indiana area only at Floyd Memorial.

Introducing Revolutionary MICS CABG

“The new procedure is called MICS CABG, which stands for minimally invasive cardiac surgery/coronary artery bypass grafting,” explained Dr. Slater. “It is part of our growing effort to approach cardiac surgery in a less invasive fashion. It can be performed through a small incision on the side of the chest instead of requiring a complete division of the breast bone. MICS allows us to avoid the risk of infection due to complete separation of the breastbone. And, as you can imagine, it means less discomfort for the patient during recovery.”

“In addition,” said Dr. Slater, “because the procedure itself is less traumatic to the body, it can offer an option for patients who are elderly or have other medical problems that might preclude them from having traditional CABG surgery. Other major benefits include a shorter hospital stay, faster recovery and better cosmetic outcome.”

“As surgeons, we are grateful to Floyd Memorial for their very forwardthinking approach in promoting the concept of minimally invasive heart surgery. It will be a distinct advantage for the people of our community.”

A. David Slater, MD
Board Certified Cardiothoracic Surgeon University Cardiothoracic Surgical
Associates, PSC Professor of Surgery at the University of Louisville

New Procedure Utilizes Leading-Edge Technology

All CABG surgeries involve bypassing a blocked artery with a vessel taken from another part of the body. This allows blood to be channeled around the blockage, restoring blood flow to the heart. In the MICS CABG procedure, the surgeon uses state-of-the-art technology to perform multi-vessel bypass procedures through an incision of just about three inches in the side of the chest. The incision is gently opened without breaking the ribs.

It is called a “window” incision because it allows the surgeon to directly visualize the be viewed with the aid of a video screen. Two other tiny incisions are made, through which instruments are inserted that position and stabilize the heart, enabling the surgeon to safely put the bypass grafts into position. The technology at Floyd Memorial was developed by Medtronic and includes the Starfish® NS Heart Positioner and the Octopus® NS Tissue Stabilizer.

The Heart Does Not Have to Be Stopped for the Procedure

Minimally invasive cardiac surgery can be done on a beating heart, which means the use of a heart-lung machine can be avoided. Rather than stopping the heart, routing the blood through the heart-lung machine, completing the bypass and then restarting the heart, the surgeon uses a stabilization system to isolate and quiet only the area he or she is working on. This is usually about the size of a quarter. The rest of the heart keeps on pumping. Eliminating the need for the heart-lung machine puts less stress on the lungs and kidneys and reduces the need for blood transfusions.

Specialized Surgical Training Is Required

The physicians who perform MICS surgery have been through advanced training and credentialing. “In order to perform this new surgery,” explained Dr. Slater, “We have visited several other top centers around the country where they are performing these procedures. We also worked directly with Medtronic, the manufacturer of the technology.”

“The new line of equipment that Floyd Memorial has acquired is used by major centers around the world,” said Dr. Slater. “We are very excited to be able to extend this procedure to our community. It gives us the opportunity to offer a surgery that is less invasive, less painful and less disruptive to the lives of our patients. And, while not everyone is a good candidate for the procedure, it can benefit many patients who need coronary artery bypass surgery.

Who Is a Good Candidate for MICS CABG?

According to Dr. Slater, “Many patients with coronary artery disease are likely to be good candidates for the minimally invasive surgery. In fact, because it is less traumatic for the body, it will make surgery an option for some people who may not have been candidates for the more invasive traditional surgery. This includes people with severe chronic obstructive pulmonary disease (COPD), those who are advanced in age, have a history of long-term steroid use, severe deconditioning, arthritis or orthopedic problems.

It can be of special benefit to people with diabetes, who tend to have more complications after conventional invasive surgery. A decision must be made on the basis of each individual’s condition, however, including the unique configuration of the blockages.” Among those who are not likely to be good candidates for MICS CABG are patients who are emergency cases, are morbidly obese, have peripheral vascular disease or who have a certain type of valve disease.

MICS CABG Offers Significant Benefits

  • Lower risk of infection with smaller incisions and less exposure of tissue
  • Does not require stopping the heart; putting less stress on the lungs and kidneys, and  reducing the need for blood transfusion
  • Less trauma for the patient
  • Less discomfort because no bones are broken during the procedure
  • A shorter hospital stay
  • Shorter recovery
  • time with fewer physical restrictions
  • Faster return to normal activities such as driving
  • Less scarring, for a better cosmetic outcome


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