Endoscopic keyhole cardiac surgery
Less invasive, minimal access surgical technique as an alternative for open heart surgery (sternotomy)
The technique provides more options for patients and can help them achieve a better quality of life more quickly, along with less pain and scarring.
Endoscopic cardiac surgery is a minimally invasive procedure to treat a wide variety of heart valve conditions, coronary artery disease, PFO and Atrial Fibrillation. Due to a smaller incision, it allows for less scarring, faster recovery time and less complications for patients. The procedure involves high-definition 3D cameras and screens to aid collaboration for greater accuracy and quality.
The Harley Street Clinic, part of HCA UK, is the only private hospital in the UK that offers totally endoscopic valve repair for the mitral and aortic valves and is leading the way in the endoscopic cardiac surgical field.
The table below outlines the main differences between open-heart surgery (a sternotomy) compared to endoscopic surgery:
|
Endoscopic heart surgery |
Standard heart surgery |
|
2.5cm incision |
11cm incision |
|
Minimal or non--existent scarring |
Scarring down the centre of the chest |
|
3-week recovery time |
Up to 6-month recovery time |
|
Multiple 3D screens for better accuracy |
Performed with human eye |
|
Under an hour in surgery |
Up to 3 hours in surgery |
Examples of scarring from standard heart surgery and endoscopic heart surgery
Left, Sternotomy post-surgery scar
Right, Endoscopic post-surgery scar
Examples of minimal scarring from endoscopic cardiac surgery
Left, example of scarring with endoscopic keyhole heart surgery on female (peri-areola)
Right, example of scarring with endoscopic keyhole heart surgery on male (right side of chest)
Mr Toufan Bahrami, Consultant Cardiac Surgeon
Toufan Bahrami has 23 years of experience in minimal access surgery. He’s performed more than 1,500 minimally invasive cardiac procedures, averaging 6-8 per week across men and women in the last year. He is responsible for performing the first private hospital resilia mitral valve replacement through an endoscopic approach at The Harley Street Clinic.
He is passionate about providing a better quality of surgery, performed through sternotomy, using a smaller incision and without opening the breastbone. His passion is endoscopic cardiac surgery, or ‘totally endoscopic’ procedures, which involve a 2.5cm incision (compared to other heart surgeries of up to 20cm) and 3D cameras and screens for enhanced accuracy and better results.
He treats patients at several of our HCA Healthcare UK hospitals including The Wellington Hospital, London Bridge Hospital and The Harley Street Clinic, the latter of which is the only hospital to offer private endoscopic heart surgery.
Speaking about the new MITRIS RESILIA mitral valve we now offer as part of our endoscopic cardiac procedures, Mr Toufan Bahrami said:
"This procedure is life changing for the patient. The integrity-preservation technology incorporated in the RESILIA tissue preserves and protects the tissue, allowing the valve to potentially last up to 30 years and avoiding the need for repeat operation. The Harley Street Clinic is the only private hospital in the UK that offers totally endoscopic valve repair and replacement for the mitral and aortic valves and is leading the way in the endoscopic cardiac surgical field."
Conditions we treat
- Mitral valve disease
- Aortic valve disease
- Tricuspid valve disease
- Coronary artery disease
- Patent foremen ovale (PFO) - hole in the heart
- Atrial fibrillation – irregular heartbeat
What procedures can be performed with endoscopic cardiac surgery?
- Coronary artery bypass / MIDCAB
- Mitral valve repair/replacement
- Aortic valve repair/replacement
- Tricuspid valve repair/replacement
- Left atrial appendage occlusion and atrial fibrillation ablation
- Patent foramen ovale (PFO) closure
- Atrial septal defect closure
What you can expect
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Initial appointment icon plus
You will discuss your medical history and symptoms with the consultant, and they will arrange imaging or diagnostic tests, and involve allied specialists if required (e.g. imaging cardiologists, interventional cardiologists, radiologists, pre-assessment team and clinical nurse specialists).
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Investigations and diagnosis icon plus
Most of the time, you will complete your cardiac invasive and non-invasive assessments and imaging during the same week and receive your results within 48 hours. Tests include:
- Echocardiogram (Transthoracic/Transoesophageal)
- Angiogram
- CT with 3D reconstruction
- Chest x-ray
- Blood tests
Your case will be presented to the specialised dedicated cardiac multidisciplinary team, who hold regular meetings to ensure the highest level of best medical practice based on GMC guidelines.
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Treatment icon plus
Having endoscopic surgery means you’ll be under general anaesthetic for around 3-4 hours. A small incision of 2.5cm will be made and the surgery will be carried out using cutting-edge technology including 4K 3D camera system with robotic arm and specific endoscopic instruments, which allows a higher level of precision and better quality of repair. For men the incision is made at the peri-areola area or on the right side of the chest; for women, it’s made at the peri-areola or underneath the chest. Once surgery is complete, small stitches will be made at the incision site to ensure minimal scarring.
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Aftercare icon plus
As a patient you will be supported throughout your journey by our one-to-one dedicated cardiac clinical nurse specialist. Immediately post-surgery you will be monitored in the intensive care unit for up to 2 days before moving to the cardiac ward of the hospital, where you will stay for around 3 days to recover. Our cardiac CNS will conduct a post discharge call within 1-3 weeks and update your consultant (you can contact them at any time – given a number). The consultant will also see you 2 weeks post-surgery at one of their NHS or private outpatient clinics.
Why The Harley Street Clinic?
✓ Specialists in endoscopic/minimally invasive heart surgery – The Harley Street Clinic was the first private hospital to perform MITRIS RESILIA valve replacement (aortic and mitral), endoscopic mitral and tricuspid valve surgery.
✓ We work with the leading consultant in endoscopic cardiac surgery, Mr Toufan Bahrami who has performed over 1,500 minimal access cardiac surgeries.
✓ The Harley Street Clinic performed over 100 minimally invasive/endoscopic cardiac procedures in the last year.
✓ We are the only private hospital offering endoscopic heart surgery in the UK.
✓ We invest in market leading, innovative technology to ensure the best patient outcomes.
✓ A personalised approach to care for every patient, considering their individual anatomy, surgical preferences and lifestyle.
✓ Current waiting times for endoscopic procedures are at least 9 months – at The Harley Street Clinic you can receive your procedure in 2-3 weeks.
Q & A
Who’s involved in my endoscopic cardiac patient journey?
What’s Mr Toufan Bahrami’s success rate with minimally invasive procedures?
100% of the degenerative mitral valves are repaired
0% conversion to sternotomy
Over 99% well-functioning, competent valves at 10 years post-surgery
How many days do I spend in the hospital?
4-5 days. Patients are discharged once they’ve been supervised and able to walk, go up and down stairs and shower.
Is it painful?
During the procedure you will be put under general anaesthetic. Post-procedure, you will have a ‘local block’ in the form of a catheter linked to the incision which injects pain relief and is removed on day three. Post-discharge there may be some discomfort for a few days, managed by pain medication.
When can I drive?
When can I fly?
4 weeks after surgery you should be fit to fly
How do I feel after surgery?
At two weeks a patient should be able to do up to 10,000 steps a day. Within four weeks patients have reported being active again and feeling positive, with minimal scarring when compared to a standard procedure.
What are the potential complications?
Post-surgery a patient could be diagnosed with atrial fibrillation, usually treated by medication. Another complication could be plural effusion (small amount of water between the lung and chest wall) which is usually treated with diuretics (urinary tablets).
Due to a smaller incision, there is far less chance of infection compared to surgeries with larger incisions such as a sternotomy, as well as no risk of a sternal disjunction. With the surgery live on-screen for theatre staff to observe, any issues during surgery can be picked up and acted on a lot faster.
What about my tricuspid valve and atrial fibrillation?
Tricuspid and ablation for atrial fibrillation can be performed at the same time as endoscopic mitral valve surgery. In fact, 40% of our patients have multiple valve procedures at the same time.
Request an appointment
If you would like to have a consultation for endoscopic cardiac surgery with Mr Toufan Bahrami, contact us today.
Call us now
020 7616 4988