NYU Approach
At NYU, the thoracotomy approach has become the standard for minimally invasive heart surgery. Instead of the standard incision through the sternum (breast bone), a small incision is made on the right or the left side of the patient’s chest. The incision length is 3-5 inches and location depends on what surgery is done.
The NYU Department of Cardiothoracic Surgery began research in less invasive forms of cardiac surgery in 1994 and introduced the Port Access approach for mitral valve surgery in an FDA sponsored trial in 1996. Since that time the use of minimally invasive heart surgery has expanded dramatically, and NYU surgeons now have experience in over 4,000 patients using these techniques.
Results have been exceedingly good, with an extremely low operative risk, less bleeding, less risk of infection, and shorter overall recovery. Follow-up studies have shown that valve repair durability is equivalent to that achieved with conventional surgery. Thus, the short term risks are reduced, with equivalent long term results.
In summary, the large and extremely favorable NYU experience with minimally invasive heart surgery suggests that this form of less traumatic surgery is now preferred for most patients requiring aortic or mitral valve surgery, for ASD repair and for atrial myxoma excision. Patients requiring coronary artery bypass are risk stratified using either conventional surgery, MIDCAB or OPCAB, which has lowered the overall risk significantly. Patients having minimally invasive heart surgery require less blood, have fewer infections and recover more quickly. These emerging new technologies are having a dramatic impact on patient care, lowering the overall morbidity, pain and suffering associated with heart surgery in the year 2007.