When Ramu (name changed), walked into my OP one morning, his face reflected both pride and apprehension. Having recently secured a job at a reputed organisation, he was the first in his family to achieve such a milestone. But during his pre-employment medical check-up, doctors detected a complex hole in the heart called a common atrium. Though symptomless for years, the diagnosis left him deeply anxious. He feared being branded a heart patient, unfit for his new role, and worried that surgery might leave a visible scar and affect his self-confidence.
Traditionally, such a defect requires open-heart surgery involving splitting the breastbone, a procedure that, while life-saving, leaves a prominent scar across the chest. However, in Ramu’s case, we opted for minimally invasive cardiac surgery (MICS), a modern technique that repairs the heart through a small incision discreetly placed under the armpit, avoiding any visible scar on the chest.
Ramu underwent the procedure successfully and was walking the very next day. He was discharged within three days and went back to work within ten days, astonishing his colleagues with his rapid recovery. When he looked in the mirror, there was barely a sign of surgery. For him, the operation was not just about healing his heart, it was about restoring his confidence and identity.
Evolution of surgical technology
Minimally invasive cardiac surgery has revolutionised the way heart operations are performed. Unlike the traditional ‘open-heart’ approach, which demands cutting through the sternum (breastbone), MICS uses smaller incisions often just two to three inches long made between the ribs. Sophisticated instruments and advanced training allow the surgeon to perform the same operations with precision through these narrow access points. Over the past decade, advances in technique and technology have made these surgeries safer, reproducible, and widely applicable.
Today, even complex heart procedures such as bypass surgery, valve repair or replacement, and closure of holes in the heart can be done using the minimally invasive approach. Nearly 80 per cent of the most commonly performed cardiac surgeries are now feasible through this route in centres with expertise.
Patient’s perspective
For patients, the benefits are immediate and tangible. The absence of bone cutting means lesser pain and faster mobility. Most individuals are discharged within 3–5 days and resume normal and even strenuous activity within two to three weeks. In contrast, traditional surgery often requires six to eight weeks for complete recovery. The cosmetic advantage is significant.
Since the incision is hidden either under the breast, between the ribs, or in the armpit, the patient retains a normal body image without the visible scar that often defines post-surgical identity. Blood loss and infection risk are far lower, and hospital stay and ICU requirements are markedly reduced.
A safer option for high risk patients
MICS has also opened doors for patients who previously faced high surgical risks. Elderly individuals and those with diabetes or other conditions that delay wound healing can safely undergo these procedures. The risk of sternal wound infection, a rare though serious complication in open surgery, is practically eliminated.
I recall a recent patient who had undergone kidney transplantation and was on immunosuppressant therapy. His risk of developing a major infection after conventional surgery would have been considerable. Through a minimally invasive approach, we performed his bypass safely with minimal postoperative discomfort and an uneventful recovery.
There are many such patients who would otherwise lose out on the long term benefits of bypass surgery due to fear of undergoing an open surgery.
Transforming experience
From the surgeon’s perspective, minimally invasive cardiac surgery demands advanced training, precision, and patience. It involves operating in a smaller space with long, fine instruments, often guided by endoscopic cameras. But the results justify the effort.
The quality of surgical outcomes measured in terms of graft patency in bypass procedures or valve function after repair is now virtually identical to that of a conventional open surgery when done by experienced teams.The patient experience, however, is profoundly different. The psychological weight of undergoing heart surgery is far lighter when the body carries no big scar to remind it. Patients walk sooner, smile sooner, and return to their lives faster.
Families, too, feel less anxiety seeing their loved ones recover swiftly without the distressing appearance of a major wound or long hospital stay.
Ramu’s story is just one among many that highlight how minimally invasive cardiac surgery is reshaping the future of heart care. For patients like him, it offers not just a better medical outcome, but dignity, confidence, and a seamless return to normal life, a true new beginning for the heart and for the person.