Differences between open and minimally invasive heart surgery

Cardiovascular surgeon Prof. Dr. Yavuz Beşoğul explains the distinctions between traditional open-heart surgery and minimally invasive (often called ‘closed-heart’) surgery.

Traditional open-heart surgery typically utilizes a median sternotomy, where the breastbone is cut down the middle to provide surgeons with wide access to the heart and major vessels. This method is advantageous for complex diseases requiring direct visualization of multiple areas. However, it requires a recovery period for the bone to heal, during which patients must avoid heavy lifting.

In contrast, minimally invasive surgery aims to reach the heart through small incisions between the ribs or limited cuts, sometimes using specialized tools, video imaging, or robotic technology. While these methods can offer a more comfortable recovery for certain valve diseases, congenital issues, or coronary artery diseases, the term ‘closed-heart surgery’ does not necessarily mean the heart is not stopped or that a heart-lung machine is not used. In many valve repairs or replacements, the heart may still need to be temporarily stopped regardless of the surgical approach.