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Cardiac Surgery - Mississauga

Trillium Health Centre Launches Minimally Invasive Heart Surgery

Patients undergoing coronary bypass surgery no longer face long and painful recoveries at Trillium Health Centre due to the introduction of minimally invasive heart surgery.

Coronary artery bypass operations involve the surgeon making a cut into the chest and sawing open the breastbone to gain access to the heart. Now, due to innovative technology introduced by Medtronic of Canada Limited and special expertise by Trillium’s cardiac surgeons, access to the heart is gained through a small cut (6 cm) between the ribs, eliminating the need to split the breastbone.

The patient benefits of this new procedure include: much less pain during recovery, less complications from wound healing, less chance of infection, less blood loss due to the breaking of the breastbone, a much faster recovery and no unsightly scars. Patients who undergo minimally invasive cardiac surgery are discharged from hospital within two to three days, a much shorter hospital stay than conventional bypass surgery which requires an average seven day hospital stay.

Trillium is already a leader in beating heart surgery with about 80% of all coronary bypass operations performed on a beating heart. Trillium is now one of only three hospitals in Canada to perform minimally invasive cardiac surgery and one of only a handful in North America. Trillium is the only hospital to have all cardiac surgeons performing the procedure.

“Trillium has perfected beating heart surgery, a gentler alternative to conventional bypass surgery where the heart is kept beating throughout the operation,” says Dr. Gopal Bhatnagar, Chief, Cardiac Surgery.“Minimally invasive cardiac surgery is a natural evolution to beating heart surgery but requires much more intense training and special expertise by cardiac surgeons.”

In the minimally invasive cardiac procedure called Multi Vessel Small Thoracotomy (MVST), state-of-the-art devices are inserted through small cuts to help stabilize and position the beating heart. The surgeon, supported by a multi-disciplinary team, grafts an artery or vein harvested from another part of the body, to bypass the narrowed area. Despite the pulsation from the rest of the heart, the surgeon is able to graft directly onto the tiny portion of the heart that has been immobilized.

Beating Heart Surgery

Older patients and patients considered high risk may not even be considered for coronary bypass surgery due to the strain this type of surgery imposes on the body.

Beating Heart Surgery image

Dr. Gopal Bhatnagar, Trillium's Chief of Cardiac Services wears surgical eye loops that allow him to view the artery being grafted three and a half times its normal size. Grace Groetzsch, RNFA, is the registered nurse first assistant during the procedure.

At Trillium beating heart surgery is providing a much gentler surgical alternative that is appropriate for many older and sicker patients. Patients that have undergone beating heart surgery experience less serious complications, recuperate faster, and are less likely to suffer an adverse event such as stroke.

Trillium Health Centre is one of only three hospitals in the Greater Toronto Area that offer beating heart surgery. Approximately 70% of all coronary bypass operations performed at Trillium are done using this procedure. That's nearly 600 beating heart surgeries a year, the most of any hospital in Canada.

During this surgery, a stabilization device presses the artery that is to be operated upon, stopping that section of the heart from beating. Despite the pulsation from the rest of the heart, the surgeon is able to graft directly onto the tiny portion of the heart that has been immobilized.

The benefits of beating heart surgery over conventional surgery are numerous and include fewer chest infections, a decrease in bleeding and the need for blood transfusions, and a lower incidence of irregular fast heart beats. Beating heart surgery also offers patients a shorter hospital stay and a quicker return to normal activities. With conventional bypass surgery there is a 2-3% death rate associated with the operation. This statistic is significantly reduced with beating heart surgery.

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