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| Guest Commentary |
by Rex Stanbridge, M.D.
St. Mary's Hospital, London UK |
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What is Minimally Invasive Cardiac Surgery?
Minimally invasive cardiac surgery was the term initially used to describe small incision approaches to the heart. The LAST and MIDCAB really moved our thinking on cardiac surgery out of the box (of sternotomy and bypass). Subsequently, limited sternotomy for aortic surgery and left lateral thorocotomy for mitral surgery found their enthusiasts, but the real bulk of discussion returned to off pump through a sternotomy. This could be argued is not minimally invasive as it is through a standard large incision.
For the patient, the incision size represents minimal but they also respect and request off-pump surgery. There are benefits in avoidance of both sternotomy and bypass. When these are combined, there is no question you have minimal invasive cardiac surgery.
There have been discussions in ISMICS regarding the name; should the MI term Minimally Invasive be replaced with Minimally invasive and Innovative? Certainly the society wishes to encompass all forms of innovative cardiac surgery where the direction is towards less invasion of tissues. This is where the true meaning of minimal invasive cardiac surgery lies.
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