Heart Surgeons to Introduce "Port-Access" -- A New Minimally Invasive Cardiac Surgery Technology -- at Strong Memorial Hospital
February 18, 1997
Minimally invasive heart surgery will become more widespread at Strong Memorial Hospital when cardiac surgeons introduce a new system this spring that enables them to "operate through a keyhole."
Known as Port-Access, the new system allows surgeons to make just one or two three-inch incisions between the Aab to perform coronary artery bypass graft (CABG) surgery or to replace or repair mitral valves in the heart.
The Port-Access technology will complement other minimally invasive techniques, which heart surgeons George Hicks, M.D. and William Risher, M.D. first introduced to the Rochester area in May of 1996; to date they have performed 15 minimally invasive coronary artery and valve procedures, which have all been highly successful.
The Port-Access system eliminates the most traumatic element of traditional cardiac surgery: no longer will it be routinely necessary for a surgeon to saw open the patient's chest (a procedure known as a sternotomy, which involves cutting through muscle, tissue, and bone) to gain access to the heart and to connect a patient to a heart-lung machine.
With the Port-Access system, a patient is connected to the heart-lung machine not at the heart but through blood vessels in a patient's thigh and neck. With the heart-lung machine "taking over" the body's circulation of blood, the patient's heart is temporarily yet safely stopped while surgeons repair the heart through small incisions or ports between the Aab.
"The new Port-Access system will give us yet another option to offer our patients," says Dr. Hicks, chief of cardio-thoracic surgery at Strong Memorial.
"For a surgeon, the key innovation is having access to all the surfaces of a still and protected heart. For the appropriate patients, we'll be able to work through these keyholes or ports to perform several kinds of cardiac procedures without having to open up the chest."
"For a patient, the innovation is a shorter hospital stay, less chance for infection or complications, and a much shorter period of recuperation," he adds.
Dr. Hicks contrasts surgery on a still heart with surgery on a beating heart. "Working on a beating heart is sometimes necessary, but it is difficult. Port-Access technology gives us the opportunity to safely stop the heart and have access to it. For many kinds of surgery, it won't be necessary to open up the patient's chest anymore."
Drs. Hicks and Risher will begin performing procedures using the Port-Access system this spring at Strong Memorial Hospital. They'll utilize the system for bypass surgery and on mitral valve repair or replacement.
In conventional coronary artery by-pass surgery, surgeons take an artery or arteries from another part of the body -- such as an arm or leg -- to replace clogged arteries and restore blood flow into the heart. As many as six arteries can be replaced during a single surgery; however, it is necessary to open the chest.
Dr. Hicks estimates that about 20 percent of cardiac surgery at Strong Memorial will eventually be performed using the Port-Access system.
After minimally invasive cardiac surgery, patients experience less discomfort and pain and experience fewer complications, such as infection. In addition, hospital stays after surgery are often shorter, reduced from six days to three or four. Once home, patients can return to normal, everyday activities in one or two weeks instead of four to twelve weeks.
The Port-Access system is a proprietary technology developed by Heartport, Inc. located in Redwood City, California. It was clinically tested at several medical centers, including the Cleveland Clinic Foundation, New York University, Stanford University, and Johns Hopkins. It received FDA approval for use in minimally invasive surgery in October of 1996.
The Port Access system consists of its "platform" -- the Endovascular Cardiopulmonary Bypass (EndoCPB-TM) System that puts the patient on a heart-lung machine via a proprietary series of catheters to the heart through blood vessels in the patients thigh and neck -- and procedure-specific kits for CABG and mitral valve repair or replacement. Heartport is developing Port-Access technology for other kinds of cardiac surgery, such as aortic valve procedures.