Minimally invasive cardiac surgery. Heart surgery for the 21st century

Cardiac surgery remained largely unchanged while other surgical specialties moved rapidly toward less invasive operations during the past 10 years. In the past year, however, heart surgery has begun to turn in a minimally invasive direction. The present feverish pace is fueled by the media and patient preference as well as commercial developments that have made minimally invasive heart surgery possible. At present, select coronary artery bypass procedures can be performed without the use of cardiopulmonary bypass or median sternotomy. Both mitral and aortic valve replacements can now be done through limited incisions that avoid sternal splitting. These minimally invasive operations probably represent the infancy of a new era of cardiac surgery. In the 21st century many coronary bypass operations will be performed as ambulatory procedures with same day or next day discharge. Patients will return to full activity within a week. Cardiac valve procedures will remain inpatient procedures with hospital stays of approximately three days and return to normal activity will occur at two weeks. We will attain these goals given the current state of the art. Imagine what vast improvements the future holds.