A smaller cut, and the same result. A Canadian-led study says a minimally invasive form of heart bypass surgery is as safe as the standard operation, and patients recovered faster after the less invasive procedure.
The study was published in The Lancet on Friday. It looked at bypass surgery, which the article describes as the most common heart surgery in the world.
“It’s the first time that any form of minimal[ly] invasive heart surgery is actually shown to be as good and even better than … the classic way of doing it,” said Dr. Marc Ruel, a cardiac surgeon at the University of Ottawa Heart Institute, who led the research.
Medical teams performed both types of surgery in a randomized trial involving 170 heart bypass patients in six countries, including Canada, between 2018 and 2024.
Traditional bypass surgery is used to treat symptoms of coronary artery disease. It involves opening a patient’s chest by cutting through the breastbone, a procedure the study says has been used for almost 60 years.
In the less invasive operation, surgeons make a five- to seven-centimetre incision on the side of the chest, leaving a smaller scar.
The study found patients who had the less invasive procedure needed fewer blood transfusions and spent less time on a breathing machine than those who had traditional surgery. Pain and time spent in hospital were similar between the two groups.
“Bypass surgery is a robust, very durable, very effective operation, but it is so incredibly invasive. And that’s what we wanted to tackle,” Ruel told CBC News.
About 15,000 people have heart bypass surgery each year in Canada, according to a 2021 study published in the Canadian Medical Association Journal.
Dr. Stephen Fremes, a staff surgeon at Sunnybrook Health Sciences Centre in Toronto who was not involved in the study, said cardiac surgery has been “a bit late to the party” in adopting minimally invasive options compared with other fields. The article says such options began to be developed in the 1990s.
Fremes said questions remain, but the findings show a less invasive option is available.
“It doesn’t mean that it’s ready for prime time, but it does show that it is possible,” he told CBC News. “And it does show that in centres where there is one or more surgeons that are dedicated to learning these procedures, that it is possible.”
Ruel also said the less invasive surgery is not suitable for every patient.
“Safety and efficacy always have to be the key priorities, not the type of incision that you have,” he said.
For Diana Wilkinson, who had the less invasive surgery at the University of Ottawa Heart Institute in 2018, the procedure has been “a success story.”
About a month after the operation, she travelled to Nicaragua. Within two years, she was climbing Kilimanjaro, the highest mountain in Africa.
“It was actually a very … simple process that I underwent,” she said. “Overall, I couldn’t have been happier and more grateful.”
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