Minimally invasive heart surgery offers patients quicker recovery

Cardiothoracic surgeon Dr. Scott Ross (left), with the help of scrub technician Joe DeLuna, cuts a two-inch incision into the chest of heart patient Caleb Davis as Ross prepares to replace a faulty aortic valve. Buy this photo

Floor-to-ceiling windows in an operating room on the fifth floor of Roper Hospital offered a stunning view of Charleston Harbor last Thursday morning, but Dr. Scott Ross wasn’t watching the water.

Heart Month

February is American Heart Month. Did you know:

Cardiovascular disease is the No. 1 cause of death in the United States.

Americans have an average of 2 million heart attacks each year, resulting in about 800,000 deaths.

About one in every four deaths in South Carolina is related to heart disease.

Controlling your blood pressure and cholesterol, quitting smoking and watching your weight are ways to help prevent heart disease.

The Centers for Disease Control and Prevention, Department of Health and Human Services

Instead, he focused his attention down a small hole that he had just cut open below Caleb Davis’s right shoulder. It was only 2 inches wide.

Davis had been anesthetized earlier that morning when it was still mostly dark outside. Blue cotton cloth was draped over the rest of his body in the operating room. From that small incision, Ross, a cardiothoracic surgeon, had access to the aorta, a major artery that has pumped blood with every beat from Davis’ heart to the rest of his body for 65 years. A valve separating the aorta from one of his heart’s chambers had hardened and turned faulty. Ross was installing a new one.

That small opening below Davis’ shoulder is what open heart surgery looks like today, at least in Ross’ world. A decade ago, this type of valve replacement would have required a surgeon to saw open Davis’ chest, breaking bones, to give the doctor space to operate on the heart inside the chest cavity. But Ross is one of a few surgeons in South Carolina who have embraced a modern, minimally invasive method, bypassing the breast bone altogether. Since 2008, he estimates he’s performed nearly 300 procedures.

Minimally invasive heart surgery takes longer than traditional heart surgery — from five to seven hours — and is more complicated for the surgical team. But it significantly shortens patient recovery, Ross said.

“At some point, everyone is going to start doing it. We’ve just been doing it (at Roper) for five years,” he said. “It’s all part of this movement into less and less invasive approaches. That’s the movement of medicine right now. Everyone is moving toward a less invasive approach, hopefully for the advantage of the patients and to allow their recovery to happen faster. That’s the goal of all these procedures, to provide the same excellent outcome, but return them to their normal activities more quickly.”

Roper St. Francis Healthcare isn’t the only hospital system switching to less invasive surgeries. Both the Medical University of South Carolina and Trident Health are embracing the techniques, too, and using them for gastrointestinal, gynecological and pediatric procedures, among a long list of other applications.

Davis, a Charleston native who raises money for athletic scholarships at The Citadel, said he was sold when his doctors told him he was a candidate for minimally invasive surgery. He had no heart blockages, his weight is normal and both his cholesterol and blood pressure are low.

“The only problem I have is the valve. It has to be replaced,” Davis said the day before his surgery. “I wasn’t scared of the heart surgery. You’re either going to make it or you won’t. What bothered me was the recuperation time.”

Doctors expect Davis to adjust to his normal activity level this spring. His recovery would have taken weeks, even months, longer if his breastbone had been broken for the surgery.

“I’ve always been very active,” Davis said. “I want to go back to that. After this, hopefully I’ll be able to.”

Reach Lauren Sausser at 937-5598.

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