Schulich school of Medicine and Dentistry logo Minimally-Invasive Cardiac Surgical Procedures Schulich Medicine & Dentistry

Procedures

  • Minimally Invasive

  • Robotic

  • Transcatheter

Minimally Invasive Mitral Valve Surgery
Minimally Invasive Aortic Bypass

View of the chest showing the retractor and aortic clamp during minimally-invasive mitral valve surgery

Atrial Ablation 

Approached through a right minithoracotomy, this technique involves femoral arterial and venous cannulation and  transmural ablation of the pulmonary veins using Cryoablation through a left atriotomy  on the arrested heart through an endocardial approach. The Right atrium can also be ablated using this approach

Atrial Septal Defect Repair

Approached through a right minithoracotomy, this technique typically involves femoral arterial and venous cannulation along with cannulation of the right internal jugular vein.  A patch repair or direct repair is then perfomed through an incision in the right atrium.

Mitral Valve Repair or Replacement

Approached through a right minithoracotomy, this technique typically involves femoral arterial and venous cannulation along with cannulation of the right internal jugular vein. Repair is performed most frequently through the placement of neochords or resection with annuloplasty. If valve requires replacement then through the same approach the valve can be replaced.

CABG Surgery

Through a lateral thoracotomy approach the left internal thoracic artery is harvested directly and then through the same incision single, double, or triple bypass can be performed using radial artery, or saphenous vein graft as other conduits

Robotic Minimially Invasive Surgery Using DaVinci Robot

Robotic Cardiac Surgery using the latest Di Vinci Robotic Platform

Robotic CABG Surgery

CABG surgery Performed at LHSC’s hybrid operating room, the Approach is through port access in the left thorax, the left internal mammary artery is harvested through the use of the DaVinci surgical system at LHSC. Anastomsis can be either performed totally endoscopic closed chest or typically performed through a left mini-thoracotomy with a direct anastomotic technique.  Confirmation of anastamotic patency is routinely performed in the operating room following the surgical procedure.

Hybrid Coronary Revascularization

Following the minimally invasive robotic-assisted anastomosis of the left anterior descending coronary artery (LAD) and confirmation of a patent left internal thoracic artery, the other diseased non-LAD coronary arteries would undergo  percutaneous coronary intervention  during the same setting (One stage) or another setting (two stage). Performed with interventional cardiologists part of LHSC’s heart team model.

Mitral Valve Surgery

Approached through the right chest with port access. Involves right femoral vein and artery cannulation and robotic-assisted mitral valve repair.

Edwards valve

Central venous cannulation for both the 16 French SVC line and 9Fr cordis prior to minimally invasive cardiac surgery

TAVI

Trans valvular aortic valve implantation utilizing either the transfemoral, transapical, direct aortic, or trans axiallary artery approach.  All procedures are performed in the hybrid operating room using a cardiac team approach with surgeons, cardiologists, and cardiac anesthesia involved in patient care regardless of the approach utilized. We are currently using or have used the following systems: Edwards Sapien XT, Medtronic Core Valve and Evolut R, and Symetis Acurate-TA and Acurate-neo

Mitral Valve Repair or Replacement 

  1. Using a transfemoral vein approach and then transseptally apply mitraclip for mitral valve repair.
  2. Transapical Implantation of valve within a previous degenerated bioprosthetic valve or native mitral valve.