Keyhole Heart Surgery

Minimally Invasive Cardiac Surgery or MICS, also known as Keyhole Heart Surgery, is the technique of performing heart surgery via tiny incisions in the chest. It does not require the chest bone or sternum to be cut as is the case with conventional open-heart surgery. While a regular operation can need a recovery time of two months, hospital stay in the case of Keyhole Heart Surgery can be as short as two days. Most patients can go home and get back to work in 10 days after a Keyhole Heart Surgery.

Quick Enquiry

What is Keyhole Heart Surgery?

  • It is an advanced type of cardiac surgery technically called Minimal access cardiac surgery (MICS)
  • Unlike the conventional heart surgery it doesn't need a sternotomy, where in the bone in the front of your chest cavity needs to be opened.
  • It can be performed through surgical wounds created on either of the sides of the chest (thoracotomy) or even through the centre of the chest (ministernotomy), sometimes , using 4-5 cm incisions.




Why keyhole ?

Keyhole /MICS procedures have many advantages to their credit

  • Small surgical wounds make one’s surgical experience great
  • Significantly less pain experience compared to the conventional procedures
  • Greatly reduced need for blood and blood product transfusion
  • Abbreviated hospital stay and early resumption of the routine
  • Excellent cosmetic outcome
  • Very less wound related complications

For which disease / diseases is / are these surgeries performed?

The keyhole/ MICS procedures are performed for a broad spectrum of diseases.

Firstly, the commonest and the leading killer disease which affects either one , two or all three of the blood vessels within the heart musculature, is the coronary artery disease. In around 20-25% of such patients bypass procedure is the treatment of choice. The same procedure which has been performed all along with the open technique , can be done with the same precision and no less effect on its long term outcome, using the keyhole strategy by experts in this field.


The second group of conditions are those that affect the valves within our heart, which can either shrink or leak, causing impediment to the natural path of blood flow. Such valves were traditionally replaced after removing one’s own valve with a prosthesis. Such diseased valves can be made as functional as their pre diseased status by repairing them through small incisions. This alleviates the need for anticoagulant medications with narrow safety margin. Interestingly, valves can be replaced as well through keyhole approach.


The next group is the yet another spectrum of disease conditions that affect our heart since birth. Commonly addressed as the ‘hole in the heart’, these are conditions allow admixture of oxygenated and deoxygenated blood inside our heart. Some of these conditions, like ASD (atrial septa defect) can also be repaired through the keyhole approach.


Lastly some of the rare yet dangerous conditions are the tumors that arise inside the heart which can be removed safely via keyhole approach.

How we do it?

Our patients planned for keyhole surgery are managed by the ‘Institute Heart Team’ experts comprising the cardiovascular and thoracic surgeons, cardiologists, cardiac anaesthetists, expert nursing team with caliber to manage these patients. Our supportive team includes the perfusion technologists ,certified echo technicians, Physiotherapists and the lab staff.

Patients are assessed for their surgical fitness with the following tests

  • Blood panel
  • Urine screen
  • Serum screen
  • X ray of chest
  • Imaging of abdominal viscera and chest
  • Pulmonary function test
  • Assessment of the carotid and peripheral arteries

Once the team decides on the procedure, the patient undergoes stabilisation of their existing medical conditions before their in house admission, the day prior of the surgery . The immediate post operative period is spent in the ICU and the rest in the ward. The average ICU stay on average is 1-2days and the total hospital stay is on an average 4-5days. Our patients spring back to their routine within a fortnight and for become fit for even international air travel within this time frame....

About Doctor

Dr Rajesh M Ramankutty MBBS, MS, MCh, MD (USA)

Dr Rajesh M Ramankutty, MBBS, MS, MCh, MD (USA), is our Chief Cardiothoracic Heart Transplant and Minimal Access (Keyhole) Cardiac Surgeon. Having pioneered the keyhole heart surgery programme in Kerala, he has performed over 5000 heart surgeries so far and is credited with performing the first heart transplant in the country in a non-metro city, in Kottayam. Winner of numerous gold medals and excellence awards, American-trained Dr Rajesh has multiple international publications to his name and has been part of national and international research programmes.

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Recognised as the best institution for Keyhole Heart Surgery in Kerala, our 635-bed state-of-the-art hospital is NABH accredited and ISO 9001:2008 certified for quality management and healthcare procedures. The Cardiology Department, which has successfully completed 25 years of selfless service to the community, offers the services of experienced Interventional Cardiologists, American-trained Cardiac Surgeons and a Cardiac Anaesthesiologist, and has earned a stellar reputation for providing effective keyhole cardiac surgery procedures for those in need.