What Every Woman Should know about heart disease

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Less-Invasive Surgery

Along with off-pump surgery, doctors have additional new options. Just a decade ago, a surgeon performing heart surgery had to make a large vertical incision down the entire length of the patient’s breastbone, then break the sternum in half and push it out of the way to get to the heart. Now there are several less-invasive ways to access the heart, which Oz helped pioneer at Columbia and describes in the award-winning textbook Minimally Invasive Cardiac Surgery (Humana Press, 2003), co-authored with Daniel J. Goldstein, M.D.

For example, surgery on heart valves, holes in the heart, and even some CABGs can be performed by making a relatively small, 3-inch incision under the breast and pushing the ribs out of the way to get at the heart without breaking any bones. These mini incisions allow for quicker recovery and, especially in women, a scar that can be completely hidden under the breast. They also cause less chronic pain than having the chest bone broken, which can ache for months or even years afterward. With no big muscles or bones cut in this procedure, the pain doesn’t last for more than a few days.
           
Another advance in minimally invasive surgery now widely performed during CABG is good news to many women: a better way of harvesting the vein from the leg to use in the bypass. Just a few years ago, the veins were removed by making an incision the entire length of the leg. This left an unsightly scar and also was extremely painful during recovery. But now the veins can be removed endoscopically, with just a small puncture, using a small instrument that sneaks under the skin, frees the vein, and allows the surgeon to pull it out. This reduces the patient’s pain as well as the rate of infection.

Things are looking brighter for people who, like Susan, never thought they would need coronary bypass surgery. These advances in surgery techniques, and a growing awareness of the difference between men’s and women’s heart disease, is comforting, just in case they do.