At Columbia, the right minithoracotomy has become the standard approach for several cardiac operations previously performed only via median sternotomy (full breastbone incision). The approach involves a 2-inch incision between the ribs in the right chest, and minimizes trauma while allowing excellent access to the heart. Examples of operations that we routinely perform through this incision include include mitral valve repair/replacement, atrial septal defect repair, cardiac tumor resection, tricuspid valve repair, atrial fibrillation surgery, or any combination of these procedures.
As with the right minithoracotomy, the left minithoracotomy offers minimally invasive access to the heart for procedures that previously required much lengthier incisions. We typically employ a left minithoracotomy for minimally invasive off-pump coronary bypass and cardiac resynchronization therapy for heart failure.
A partial incision of the breastbone, a hemisternotomy offers an alternative to the median sternotomy or full incision of the breastbone. The smaller incision allows access to the aortic valves for aortic valve replacement surgery, while decreasing the risk of sternal wound complications.
Robotic (Totally Endoscopic) Cardiac Surgery
Columbia surgeons have the largest U.S. experience in robotic cardiac surgery. Robotic surgery employs several very small incisions that provide access for the robotic instruments and a camera. The robot's wrists hold the tools, providing human-like range of motion and mimicking the motions made by the surgeon, sitting at the console in the operating room. The robotic cardiac surgical team at NYPH/Columbia currently performs the following procedures:
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