By: Abdi Waluyo Hospital

Overview

What is Minimally Invasive Cardiac Surgery (MICS)?

Minimally Invasive Cardiac Surgery (MICS) is an advanced surgical technique that allows surgeons to perform complex heart operations through small incisions between the ribs instead of the traditional median sternotomy (splitting the breastbone). By avoiding a full chest incision, MICS minimizes surgical trauma while providing the same treatment effectiveness as conventional open-heart surgery for appropriately selected patients.

Depending on the patient’s condition, MICS may be performed to treat:

Coronary artery disease requiring coronary artery bypass grafting (CABG)
Mitral valve disease
Tricuspid valve disease
Atrial septal defect (ASD)
Cardiac tumors
Selected congenital heart diseases
Certain heart rhythm disorders

Compared with conventional open-heart surgery, MICS offers less pain, reduced blood loss, lower risk of infection, faster recovery, shorter hospitalization, and improved cosmetic results.

At RS Abdi Waluyo, Minimally Invasive Cardiac Surgery is performed by an experienced Cardiac Surgery Team using advanced surgical techniques and supported by a state-of-the-art Hybrid Catheterization Laboratory (Hybrid Cath Lab), enabling seamless collaboration between cardiac surgeons, interventional cardiologists, anesthesiologists, cardiac imaging specialists, and intensive care teams.

Why is Minimally Invasive Cardiac Surgery Performed?

Your cardiologist or cardiac surgeon may recommend MICS to treat:

Severe coronary artery disease
Mitral valve regurgitation or stenosis
Tricuspid valve disease
Atrial septal defect (ASD)
Benign cardiac tumors, such as atrial myxoma
Selected congenital heart defects
Patients who are suitable candidates for minimally invasive cardiac surgery

MICS aims to restore heart function while reducing surgical trauma and promoting a faster recovery.

Details of the Procedure

Before surgery, you will undergo a comprehensive evaluation, which may include:

Consultation with a cardiac surgeon and cardiologist
Blood tests
Electrocardiography (ECG)
Echocardiography
Coronary Angiography or Coronary CT Angiography
Cardiac CT scan
Chest X-ray
Pulmonary function tests when indicated

Before surgery, you may be instructed to:

Fast for several hours
Temporarily discontinue certain medications, such as blood thinners
Stop smoking before surgery
Inform your healthcare team of allergies or other medical conditions

The operation generally takes 3 to 6 hours, depending on the complexity of the procedure.

What Happens During the Procedure?

During MICS:

General anesthesia is administered
A small incision, typically 4–8 cm in length, is made between the ribs on the right or left side of the chest
Specialized long-shafted surgical instruments and high-definition cameras are used to access the heart
Depending on the condition being treated, the surgeon performs valve repair or replacement, coronary artery bypass surgery, closure of congenital defects, or removal of cardiac tumors
Advanced imaging and surgical guidance ensure precise treatment while minimizing trauma to surrounding tissues
After the procedure is completed, the incision is closed using cosmetic techniques

Throughout the operation, your heart function, blood pressure, oxygen levels, and other vital signs are continuously monitored

What Should I Expect After Surgery?

Following MICS:

You will initially recover in the Intensive Care Unit (ICU)
Most patients are transferred to a regular cardiac ward within one to two days
Hospital stay is typically 4 to 7 days, depending on recovery
Pain is generally less than with conventional open-heart surgery
Walking is encouraged as early as possible
Most patients resume normal daily activities within 2 to 6 weeks, considerably faster than after conventional sternotomy

Your healthcare team will provide instructions regarding wound care, medications, activity, and cardiac rehabilitation

What Are the Risks?

Although MICS is considered safe and effective, all cardiac surgery carries potential risks, including:

Bleeding
Infection
Stroke
Heart rhythm abnormalities
Blood clots
Heart attack
Lung complications
Kidney dysfunction
Need to convert to conventional open-heart surgery if necessary
Death (rare)

Your surgical team carefully evaluates every patient to minimize these risks.

Results and Follow-Up

After surgery, your cardiac surgeon and cardiologist will evaluate:

Success of the surgical repair
Heart valve function
Coronary blood flow, when applicable
Cardiac function
Symptom improvement
Overall recovery

Follow-up care may include:

Regular clinic visits
Echocardiography
Electrocardiography (ECG)
Cardiac rehabilitation
Medication management
Lifestyle modification to promote long-term cardiovascular health

When Will I Know the Results?

Your cardiac surgeon will discuss the initial results shortly after surgery

During your hospital stay, additional evaluations—including echocardiography and clinical assessments—will confirm the success of the procedure before discharge

If the Results Are Abnormal, What Are the Next Steps?

If additional treatment is required, your Heart Team may recommend:

Medication adjustments
Additional cardiac imaging
Catheter-based intervention
Repeat surgery (rare)
Cardiac rehabilitation
Ongoing follow-up with your cardiologist and cardiac surgeon

Treatment recommendations will depend on your specific condition and overall health

When Should I Call My Doctor?

Contact your doctor immediately if you experience:

Fever
Increasing chest pain
Shortness of breath
Redness, swelling, or drainage from the incision
Persistent palpitations
Leg swelling
Sudden weakness or dizziness
Any new or worsening symptoms

Seek emergency medical attention immediately if you develop severe chest pain, stroke symptoms, difficulty breathing, or loss of consciousness.

Why Choose RS Abdi Waluyo for Minimally Invasive Cardiac Surgery?

At RS Abdi Waluyo, our Cardiac Surgery Program combines advanced surgical expertise, innovative technology, and a multidisciplinary Heart Team approach to provide world-class treatment for patients with cardiovascular disease.

Our Minimally Invasive Cardiac Surgery program offers:

Advanced Hybrid Catheterization Laboratory (Hybrid Cath Lab) integrating a modern operating room with advanced cardiovascular imaging for greater precision and patient safety.
Experienced cardiac surgeons specializing in minimally invasive heart surgery and complex cardiovascular procedures.
Comprehensive Heart Team collaboration, involving cardiac surgeons, cardiologists, interventional cardiologists, cardiac imaging specialists, anesthesiologists, intensivists, and rehabilitation specialists.
Smaller incisions, resulting in less pain, reduced blood loss, lower infection risk, and improved cosmetic outcomes.
Faster recovery, allowing earlier mobilization, shorter hospital stays, and quicker return to work and daily activities.
Comprehensive cardiac services, from advanced diagnostics and cardiac imaging to surgery, rehabilitation, and long-term follow-up.
Patient-centered care focused on clinical excellence, safety, comfort, and long-term cardiovascular health.

By combining minimally invasive surgical techniques, advanced Hybrid Cath Lab technology, and an experienced multidisciplinary Heart Team, RS Abdi Waluyo provides comprehensive, personalized cardiac care that delivers outstanding clinical outcomes while helping patients recover faster and return to their daily lives with greater confidence.