Surgeons Refine the Procedure

The first version of Heartport's system was based on endoscopic, televised visualization of the surgical field, with surgery performed indirectly with extended instruments inserted through small openings, or ports. But that proved difficult to manage. "The real breakthrough came when Dr. Colvin realized that he could forego the endoscope, directly visualize the heart, and perform surgery very much as we have always done with standard instruments," notes Dr. Galloway. Heartport's endovascular system - which positions the blood flow devices largely outside of the operative field - allows the surgery to be done through a small incision.

"...Dr. Colvin realized that he could forego the endoscope, directly visualize the heart, and perform surgery very much as we have always done... "

This significant modification, introduced by NYU's cardiac surgeons, encouraged widespread adoption of this technology, according to Dr. Galloway. "Minimally invasive cardiac surgery could now be done essentially with conventional visualization and surgical techniques, instead of being dependent on futuristic televised microscopic imagery and remote instrumentation . We also could be confident of the results, since we're basically using traditional surgical techniques." Dr. Galloway explains that close collaboration with Heartport was very productive. "We told them that instead of a video system we could use a retractor to help us operate while viewing the heart, and they responded immediately by developing the retractor."

More Patients Can Benefit

The first application of the Port-Access approach was for single-vessel bypass, but it soon became clear that the technique didn't need to be so restricted. In May 1996, the world's first Port-Access mitral valve repair was performed at NYU. Dr. Colvin found that the Port-Access technique with direct visualization works exceptionally well for valve surgery. "The position of the mitral valve often makes visualization better coming through a small incision toward the side rather than through the front with traditional sternotomy," he explained. Port-Access techniques were extended to multi-vessel coronary bypass when Dr. Colvin performed the world's first minimally invasive triple bypass using the Port-Access system on Thanksgiving Day of 1996.

Port Access: A new Era in Cardiac Surgery

Key Features:

• Closed Chest
  (No Sternotomy)
• Motionless Heart
• Standard Visualization
  and Instruments
• Broad Applicability
  • Coronary bypass - single or multi-vessel
  • Mitral valve repair and replacement
  • Aortic valve replacement (modified)
  • Atrial septal defect repair