Mr Toufan Bahrami
Consultant Cardiac Surgeon, Royal Brompton & Harefield Hospitals Specialist Care
Leading cardiac surgeon uses a new totally endoscopic approach to repair and fit new heart valves in patients, with several benefits over open heart surgery.
A new, minimally invasive, completely endoscopic (keyhole technique) surgery is helping heart patients recover quicker after operations.
Keyhole surgery
Heart valve surgery traditionally involves opening the breastbone and performing the operation through a 20cm incision.
In several UK centres, surgeons offer a less invasive approach with a smaller incision on the patient’s side. But Royal Brompton & Harefield Hospitals Specialist Care in London is the only UK centre now using a new technique for mitral valve repair and aortic valve replacement.
Higher precision
Consultant cardiac surgeon Mr Toufan Bahrami, who is nationally and internationally recognised in minimally invasive, endoscopic cardiac surgery, explains how the novel approach avoids a large incision or division of the sternum.
The surgeon enters the chest through a tiny cut and spreads the soft tissue. With another incision, he uses a 4K resolution 3D camera that shows the inside of the chest via a high-definition TV monitor in the operating theatre.
Endoscopic instruments are mechanically manipulated, though the surgeon is next to the patient to intervene manually if required.
Patients of all ages are eligible for the technique, which has a much faster recovery time.
Quicker recovery
Patients of all ages are eligible for the technique, which has a much faster recovery time.
“During open heart surgery, the breastbone is opened, recovery takes three months and patients cannot drive or lift anything heavy for two months,” he says. With that approach, recovery is one month. But with totally endoscopic heart surgery, patients can return to normal daily activity within three weeks.
“Because the chest is not opened, they can breathe faster, mobilise quicker and recover quicker. This technique is a game-changer for patients, reducing the risk of infection and the length of time in hospital,” says Mr Bahrami.
Compared to other techniques, the length of operations is similar, but hospital stay is reduced by one to two days, and the result looks better because of minimal scarring.
Training and teaching
The approach has training advantages too, as the procedure is displayed on monitors and can be recorded. Mr Bahrami says 4K image quality on the monitor also enables a more accurate assessment of organs.
“To me, this is the future of cardiac surgery; and any patient, whether low risk or high risk, can have this operation,” he adds.
Having conducted many operations, Mr Bahrami trains other surgeons in the technique and works with surgical companies to develop and improve the procedure further.
