Temple University Health Sciences Center
Contact: Denice Ferrarelli (215) 707-7787
Temple University Hospital Performs World's First Minimally Invasive Combined Cardiac Surgery
PHILADELPHIA -- Cardiac surgeons at Temple University Hospital have performed the first-ever combined coronary artery bypass graft and heart valve replacement surgery without cutting open the patient's chest.
Using a new, minimally invasive surgical technique called Port Access, Temple surgeons performed the combined procedures -- the replacement of a diseased mitral valve and the shunting of a blocked coronary artery in a 49-year-old Philadelphia man -- through two small incisions, or "ports," made in the patient's chest wall between the ribs.
The technique eliminates the need to crack open the patient's breastbone to reach the heart, which is considered one of the most traumatic aspects of "open-heart" surgery. The new, minimally invasive approach is expected to reduce the pain, trauma, and scarring caused by the typical foot-long incision required in conventional open-chest surgery, as well as minimize the risk of such complications as infection, hasten recovery time and improve the quality of life for heart-surgery patients.
"With this new, minimally invasive approach, we expect patients to resume their normal lives much more quickly," said Temple's chief of cardiac surgery V. Paul Addonizio, who performed the world-first operation yesterday (1-23-97). Most patients will be able to leave the hospital in three or four days and recover fully in one to two weeks, Addonizio said, adding that those time frames "compare very favorably to the week or more that patients often stay in the hospital after conventional heart surgery, and the subsequent two- or three-month convalescence period."
The new, minimally invasive technology incorporates what many surgeons consider the most important advantages in open- chest surgery, namely, stopping and protecting the heart and supporting the patient's circulatory system with cardiopulmonary bypass -- a heart-lung machine -- while the heart is being repaired. Cardiopulmonary bypass has been the standard in open-chest surgery for nearly 40 years and is widely credited with making such surgery safe and effective. Because the heart is stopped in port- access surgery, surgeons have the flexibility to perform a wide range of cardiac operations, are able to operate with a high degree of precision and accuracy, and can easily manipulate the heart to perform even complex repairs.
To perform port-access surgery, doctors stop the heart and connect the patient to a heart-lung machine using specially designed catheters and devices threaded to the heart through blood vessels in the thigh and neck. Surgeons then repair the heart in the same way they do in open-chest surgery, but instead operate through a single three- to four-inch incision in the chest wall.
"This procedure enables us to retain the important advantages of cardiopulmonary bypass and, because the technique is applicable to a broad range of cardiac repairs, brings the benefits of a minimally invasive approach to a large number of heart patients," Addonizio said.
In addition to performing the world's first minimally invasive combined cardiac procedure, Temple University Hospital also is the first in Philadelphia to use the minimally invasive approach for heart valve replacement.
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