MICS VS Open Heart Surgery

Cardiac Surgery | by Dr. Manoj Kumar Daga | Published on 10/09/2024

Anybody's experience with heart surgery is significant and frequently accompanied by concerns and anxiety. Patients are frequently given the choice between open heart surgery and minimally invasive cardiac surgery (MICS) when they require heart surgery. While they both seek to address cardiac problems, their methods, rates of recovery, and overall effects on the patient's life are extremely different. There is a need for less intrusive and more effective treatment options for heart disease since it continues to be one of the top causes of mortality.

With the aim of less trauma and faster recovery times than open cardiac surgery, MICS provides a modern option. To make an informed choice, you must, however, be aware of the differences, advantages, and possible risks associated with each alternative. To help you or a loved one decide which procedure would be best for you, we'll examine the subtle differences between MICS and open heart surgery in this blog. If you are facing any heart related issue, book your appointment with one of the best cardiologists at BM Birla Heart Research Hospital in Kolkata for state-of-the-art facilities and proper care.

What is MICS vs. Open Heart Surgery?

Open Heart Surgery and Minimally Invasive Cardiac Surgery (MICS), are two different surgical techniques.

• MICS: MICS does not need opening the breastbone, and instead uses smaller incisions, usually in the space between the ribs. This method shortens recovery periods, lessens physical damage to the body, and lessens pain following surgery. Procedures including atrial septal defect closure, coronary artery bypass, and valve repairs are frequently performed using MICS.
• Open heart surgery: It requires a bigger incision, which gives the surgeon direct access to the heart. With more complicated cardiac diseases, this conventional method is frequently required and gives the surgeon better access to and visibility into the heart's architecture. 

What Are the Benefits of MICS vs. Open Heart Surgery?

Minimally Invasive Cardiac Surgery (MICS) and Open Heart Surgery offer distinct benefits depending on the patient's condition and the specific procedure.

Benefits	Minimally Invasive Cardiac Surgery (MICS)	Open Heart Surgery
Incisions	Smaller Incisions	Full access to the heart for complex procedures
Risk of Infection	Reduced Risk of Infection	Effective for severe conditions like coronary artery disease, valve replacements, and congenital defects
Hospital Stay	Shorter Hospital Stay, typically 3-5 days	Results are durable, providing long-term relief
Recovery Time	Faster Recovery Time	Multiple heart-related procedures can be carried out during a single operation
Pain and Discomfort	Less Pain and Discomfort	Proven success rate with well-documented outcomes
Cosmetic Outcomes	Improved Cosmetic Outcomes	Thorough and precise repairs to restore optimal heart function

What are the Symptoms Indicating the Need for MICS vs. Open Heart Surgery?

When a patient has symptoms that indicate serious cardiac disease, either open heart surgery or MICS may be necessary. Among these signs are:

• Angina's chest pain: Continuous chest pain or discomfort, particularly when exercising, could be a sign of clogged coronary arteries that need to be surgically cleared.
• Breathlessness or difficulty breathing: It may indicate cardiac valve issues or heart failure, which may require surgery.
• Fatigue: Excessive exhaustion or weariness that interferes with day-to-day activities could indicate a cardiac issue that requires surgery to treat.
• Palpitations: If irregular heartbeats or palpitations are accompanied by disorders such as atrial fibrillation, surgical intervention may be necessary.
• Edema: Swelling in the belly, legs, or ankles may be a sign of heart failure and frequently call for surgery.
• Syncope: To address underlying cardiac problems, surgical investigation may be necessary for fainting spells, especially those that are associated with exertion.

What are the Causes Leading to MICS vs. Open Heart Surgery?

MICS or open heart surgery may be required in the following conditions:

• Coronary Artery Disease (CAD): Depending on the location and degree of the blockages, either approach may be used during CABG surgery, which is frequently the result of coronary artery blockages.
• Heart Valve Disease: Disorders such as regurgitation or stenosis of the heart valves may need surgery for replacement or repair.
• Congenital cardiac defects: Depending on the size and location of the defect, surgical repair may be necessary for problems that are present from birth, such as ventricular septal defects (VSDs) or ASDs.
• Aneurysms: If an aortic or cardiac aneurysm is not treated, it may burst, posing a serious risk to life and necessitating rapid surgical intervention.
• Arrhythmias: When medicine is ineffective in treating abnormal cardiac rhythms, surgical correction often accomplished using MICS may be necessary.

What are the Risks and Complications of MICS vs. Open Heart Surgery?

Both MICS and Open Heart Surgery carry inherent risks and potential complications, although the extent and nature of these differ:

MISC	Open Heart Surgery
Bleeding: It is rare but can occur	Infection: The chance of infection is higher with a larger incision.
Infection: Chances are rare, but it’s still a possibility.	Longer Recovery: Following open cardiac surgery, recovery is typically more painful and drawn out.
Inadequate Repair: Limited visibility might lead to incomplete repair, necessitating further surgery.	Bleeding: There is a higher chance of severe bleeding when the body sustains more damage.
Stroke: Any heart operation carries a risk of stroke.	Stroke: During the process, there is a risk of stroke, similar to MICS

What Are the Pre-instructions of MICS vs. Open Heart Surgery?

To ensure the best possible result, meticulous planning and adherence to detailed instructions are necessary while preparing for MICS or open heart surgery.

Pre-Instructions	Minimally Invasive Cardiac Surgery (MICS)	Open Heart Surgery
Preoperative Testing	Includes blood tests, chest X-rays, and an ECG	Includes comprehensive testing such as blood tests, chest X-rays, ECG, and possibly echocardiography.
Medications	Discontinue certain medications as advised by the surgeon; usually involves fewer modifications.	Often requires more extensive medication adjustments; specific instructions on blood thinners and other drugs.
Fasting	Generally, fasting for 6-8 hours before surgery.	Similar fasting requirements, typically 6-8 hours, but may involve additional pre-surgical dietary limitations.
Pre-Surgical Consultation	Detailed discussion with the surgeon about the procedure; often less complex.	In-depth consultation including discussing risks, benefits, and the surgical plan.
Health Preparation	Instructions to maintain general health; may include light exercises if permitted.	Extensive preparation, including pre-surgical physical conditioning and possibly pre-surgery therapies.
Transportation and Support	Arrange for transportation to and from the hospital; consider having a support person.	Arrange for transportation and a support person due to the more intensive nature of the procedure and recovery.
Preoperative Instructions	Follow specific instructions regarding skin preparation and bathing with antiseptic.	Detailed preoperative instructions often include special skin preparation, bowel cleansing, and additional pre-surgical hygiene protocols.

What Are the Post-instructions of MICS vs. Open Heart Surgery?

There aren't many major differences in the post-operative instructions between Minimally Invasive Cardiac Surgery (MICS) and traditional open-heart surgery. Both procedures require patients to diligently follow the aftercare guidelines provided by their doctors. Even though recovery from MICS is typically faster due to the less invasive nature of the procedure, this doesn’t mean patients can skip or overlook the prescribed instructions. Cardiologists emphasise the importance of adhering to all post-surgery care until full recovery is achieved.

Surgeons usually recommend following these guidelines, which include wound care managing medications, attending follow-up appointments, limiting physical activity, proper nutrition, and monitoring for any signs of complications, regardless of how quickly one feels better after surgery.

What Does Recovery After MICS vs. What Does Open Heart Surgery Look Like?

Here are the differences between MICS v/s open-heart surgery when it comes to recovery:

Aspect	Minimally Invasive Cardiac Surgery (MICS)	Open Heart Surgery
Hospital Stay	3-5 days	5-7 days
Pain Management	Some discomfort around the incision; prescription painkillers can help	Some discomfort around the incision; prescription painkillers can help
Gradually Resuming Activities	Resume normal activities earlier; start with mild activities and gradually increase over weeks	May take up to a month to resume normal activities
Cardiac Rehabilitation	Take part in a program that combines education, counselling, and closely supervised exercise to aid in your recovery, if advised	Participate in a program that includes education, counselling, and supervised exercise if advised
Long-Term Recovery	6 to 12 weeks	3 to 6 months
Lifestyle Modifications	Adopt a heart-healthy diet, frequent exercise, and stress reduction for long-term health	Adopt a heart-healthy diet, frequent exercise, and stress reduction for long-term health

While the recuperation period for MICS and Open Heart Surgery differs, it usually consists of multiple phases.

Conclusion

Making the important decision between Minimally Invasive Cardiac Surgery (MICS) and Open Heart Surgery is dependent on several factors, such as the patient's general health, the intricacy of the heart issue, and the advantages and disadvantages of each procedure. To choose the best course of action, it is imperative to speak with a cardiothoracic surgeon as both treatments offer benefits and drawbacks. 

Patients now have more alternatives than ever thanks to medical technology breakthroughs, which enable individualised treatment programs that provide the best results. The objective is always the same, whether open heart surgery or MICS: to improve quality of life and restore cardiac health.

FAQs

Is open heart surgery and bypass surgery the same?

Despite their frequent interchangeability, open heart surgery and bypass surgery are not the same. Open heart surgery is a general term for a variety of cardiac treatments carried out with the chest open, whereas bypass surgery particularly refers to constructing new paths for blood to bypass blocked arteries.

What is the difference between bypass and open heart surgery?

Any procedure done on the heart with the chest open is referred to as open heart surgery, which includes procedures for congenital abnormalities as well as valve replacements and repairs. A particular kind of open heart surgery called bypass surgery, also known as coronary artery bypass grafting (CABG), reroutes blood around clogged coronary arteries.

What is minimally invasive cardiac surgery?

Compared to traditional open heart surgery, minimally invasive cardiac surgery uses tiny incisions and specialist techniques to perform heart treatments with less damage to surrounding tissues, quicker recovery times, and less postoperative pain.