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An interview with
M. Alan Martin, MD, Cardiothoracic Surgeon, Northwest Surgical Associates, div. of The Oregon
Clinic
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While many of today’s interventional cardiac procedures can be done using minimally-invasive technology, traditional open heart surgery still requires that doctors open the chest in order to reach the heart. In preparation for bypass surgery, veins that are used to repair the heart are removed from the patient’s leg, leaving painful wounds that are often several inches long and take many weeks to heal. Now another breakthrough in the use of less-invasive technology allows doctors to reach the veins through tiny incisions, resulting in faster healing for the patient and very little scarring.
Endoscopic technology is at the heart of today’s minimally-invasive procedures. It allows doctors to reach certain areas of the body through the use of catheters and scopes that travel through major arteries. For people having by-pass surgery, the ability to remove veins from the legs without making large incisions results in a major improvement in their comfort and care.
The same idea is being applied by cardiothoracic surgeons for replacing heart valves. Instead of reaching the heart through the front of the chest, which requires a major incision, doctors can now replace heart valves by making a modest incision through the ribs. While the scar is smaller and heals more quickly using the less-invasive approach, it can actually result in a more painful recovery than traditional open surgery because the access point is through the ribs. Not everyone is a candidate for this type of surgery, so the technique is currently used only in a select group of people.
Another exciting use for minimally-invasive technology is for treating atrial fibrillation, a heart rhythm disorder which is common among seniors. Atrial fibrillation can be fixed during open heart surgery, when the physician has easier access to the heart. The ability to reach the cause of the arrhythmia with catheter-based technology means it has the potential to be done as its own procedure, separate from open heart surgery. For now, however, the surgery for atrial fibrillation is most commonly done in combination with open heart surgery.
There are many advances on the horizon for cardiothoracic surgery, all designed to minimize the impact of surgery on the patient, as well as improve design and function of the many devices we use to repair the heart. Leading cardiovascular facilities, such as the Heart & Vascular Center at PeaceHealth Southwest, have the physician expertise and technology to bring these advances home to Clark County.
Published February 2008.
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