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An Overview of Minimally Invasive Heart Surgery

6/29/2025

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​Heart surgeries are often complex and daunting. However, recent decades have seen significant advancements in surgical techniques, making heart surgeries safer, more precise, and less invasive. One such advancement is minimally invasive heart surgery (MIHS), which is performed through small incisions, typically between the ribs. Unlike traditional surgeries that require cutting through the sternum, this method allows surgeons to access the heart using robotic assistance or endoscopic tools for greater precision.

There are different types of MIHS. Some of the more popular forms are minimally invasive coronary artery bypass, or CABG, atrial septal defect (ASD) repair, maze procedures for atrial fibrillation, transcatheter aortic valve replacement (TAVR), and valve repair or replacement.

Beyond its aesthetic value, MIHS has many surgical benefits. Smaller incisions result in less physical trauma, reducing the risk of infection during and after the procedure. The smaller the incisions, the less blood loss and the lower the need for transfusions.

MIHS also promotes faster recovery and significantly shortens hospital stays, often reducing them by half compared to traditional surgery. Postoperative pain is reduced because there is no major bone cutting involved. Cosmetic results are improved as MIHS creates smaller, less noticeable scars. This procedure also carries fewer complications, which is especially important for patients with pre-existing conditions and older adults, who are more prone to complications.

MIHS relies heavily on both advanced technology and highly skilled surgeons. Using tools like high-definition 3D cameras, robotic arms, and tiny precision instruments, surgeons can operate with remarkable accuracy even in tight spaces around the heart. Leading cardiac centers, such as Cardiac Surgery Associates, are known for their dedicated teams that blend cutting-edge technology with years of hands-on experience to deliver tailored, high-quality care to each patient.

Getting ready for an MIHS means taking a few important steps to help ensure everything goes smoothly. Before the procedure, the patient care team runs some tests, like blood work and heart imaging, to confirm the patient is a good fit for this type of surgery. In the days leading up to surgery, doctors usually recommend quitting smoking, eating well, and staying gently active if possible to boost heart and lung health. On the day itself, the patient is required to fast and carefully follow all instructions from the surgical team to reduce risks and support a healthy recovery.

MIHS has a shorter recovery time than open-heart surgeries, which makes recovery and postoperative care significantly easier. With MIHS, patients can get on their feet and even go home in a couple of days. Although full recovery from MIHS might take a week, it has a significantly smoother rehabilitation process compared to open-heart surgeries. While recovering, patients are usually advised to participate in cardiac rehabilitation programs, follow up regularly to achieve the best long-term outcomes, and maintain healthy habits.

As surgical technology advances, minimally invasive heart surgery is becoming a more common and effective option for many patients. Improved tools, refined techniques, and greater surgical expertise are helping make this approach a new standard in cardiac care. For anyone facing heart surgery, it’s important to explore all available options, including minimally invasive procedures, since they often offer quicker recovery and fewer complications.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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Bringing Cardiac Care Closer - How Regional Networks Save Lives

6/11/2025

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​High-quality cardiac care remains out of reach for many people living outside major cities. Advanced surgical services tend to cluster in metropolitan areas, leaving rural and suburban patients with fewer options when emergencies strike or chronic conditions worsen. This uneven distribution creates delays, lowers survival rates, and adds stress for individuals already navigating serious health concerns.

To close this gap, regional health systems are expanding through connected networks that cross geographic boundaries. These systems bring advanced cardiac services to areas that previously offered only basic care. By linking hospitals, clinics, and surgical teams across multiple locations, patients can access timely treatment without traveling long distances for every consultation or procedure.

Hospital partnerships make regional care possible. Standardized credentialing, fast transfer protocols, and joint case reviews connect smaller sites with high-volume centers. Direct access to surgeons and imaging specialists enables faster, more coordinated decisions.

Telemedicine expands that access even more. Virtual consultations and remote diagnostic tools allow cardiologists to assess patients early, well before symptoms become severe. Portable devices for imaging and heart monitoring support initial evaluations nearby. Earlier detection leads to more treatment options and better outcomes.

Regional networks do more than handle emergencies - they help catch heart issues early. By spotting risks before symptoms show up, they give patients a chance to manage their health sooner and avoid major procedures. That can mean regular checks on blood pressure, cholesterol, and heart function, delivered locally. In many cases, early care like this helps prevent the need for surgery.

Complex procedures like valve repairs, bypass surgery, and ablations are still done at specialized centers. However, recovery can take place locally. This hybrid model preserves procedural quality while extending recovery services throughout the network, enabling patients to heal near family and support systems.

Operating a regional system requires careful coordination. Credentialing must be consistent across sites to uphold shared standards. Staffing plans must allow flexible coverage, especially in low-volume areas. Real-time performance tracking ensures care quality remains consistent across the network, regardless of facility size or location.

Training reinforces this infrastructure. Clinicians must be comfortable using digital tools, managing care across sites, and adapting to evolving protocols. Education now includes simulations, remote supervision, and clinical rotations to prepare teams for regional collaboration while upholding high standards of care.

Strong regional care systems often team up with local organizations to support patients after they leave the hospital. This can mean working with rehab centers, transportation services, or support groups that help people keep their recovery on track. Community partnerships help patients maintain follow-up care and manage long-term recovery more easily.

Patients benefit in concrete ways. Shorter travel times reduce costs, limit time away from work, and ease emotional burdens. Coordinated care moves faster, cutting wait times for tests, consultations, and surgeries. In urgent situations, such as heart failure or unstable angina, hours saved can directly impact survival.

This model also drives meaningful change at the population level. By spreading access to specialized cardiac services, regional networks help reduce survival disparities linked to geography. Communities that once lagged in outcomes now receive care equal to what urban centers offer. This shift supports a more equitable healthcare system overall.

The same framework can guide other high-acuity specialties. Stroke response, trauma care, oncology, and other complex services benefit from regional designs that deliver advanced treatment across wider areas. As healthcare delivery evolves, these systems demonstrate that access and excellence can grow together.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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From Preparation to Recovery - Systems That Strengthen Cardiac Surgery

5/15/2025

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​Cardiac surgery has moved beyond the operating room. Today, it unfolds as a continuum of care that begins with early risk evaluation and extends into the weeks and months after discharge. Clinical outcomes are no longer defined by surgical skill alone, but by how well each phase of treatment connects with the next.

The process begins with thorough preoperative evaluations. Diagnostic tools like imaging, blood tests, and risk scoring systems help uncover conditions that could complicate recovery. When issues such as reduced lung function or anemia are caught early, surgical plans can be adjusted to avoid setbacks. In many cases, this early detection reduces both complications and hospital readmissions.

Planning doesn’t stop with diagnostics. Collaborative preparation among cardiologists, surgeons, anesthesiologists, and advanced care teams defines a patient’s path forward. These meetings help clarify roles and align treatment objectives, making surgery safer and post-operative care more consistent. When providers start from a shared plan, patients benefit from fewer gaps and more focused interventions.

Inside the operating room, precision tools support each decision. Real-time monitoring of heart function, blood flow, and vital signs allows teams to adapt quickly as conditions change. Surgeons also rely on robotic instruments and enhanced visuals to improve accuracy during complex procedures. These innovations can shorten recovery time by reducing trauma to healthy tissue.

The first few days after surgery often carry the highest risk. Hospitals now use structured care pathways that address mobility, breathing support, and pain control beginning right after surgery ends. These protocols improve blood flow, lower infection rates, and encourage faster stabilization, which helps reduce the length of stay for many patients.

Programs like Enhanced Recovery After Surgery, or ERAS, bring additional structure to recovery. These systems standardize fluid management, anesthesia, and rehabilitation, helping patients regain strength and resume normal function sooner. ERAS protocols also allow for earlier removal of invasive lines and guide smoother transitions to home-based care.

In parallel, nutritional support is gaining more attention as a critical element in healing. Tailored meal plans that address protein needs, hydration, and caloric intake help rebuild tissue and support immune function. Hospitals increasingly coordinate with dietitians to ensure patients are well nourished throughout recovery. This added focus can influence energy levels, wound healing, and long-term cardiac health.

Once discharged, patients still need support. Wearable monitors now collect real-time data on heart rate, rhythm, and mobility, which clinicians can review remotely. This constant feedback loop allows care teams to intervene early if problems emerge, especially during the high-risk period immediately following surgery.

Patient education remains central to recovery at home. Before discharge, care teams review medications, activity guidelines, and warning signs that should prompt follow-up. Clear instructions make it easier for patients and caregivers to manage recovery with confidence, which lowers the chances of avoidable complications.

Ongoing coordination across providers is also essential. Shared electronic records, follow-up appointments, and virtual visits ensure that primary care physicians, specialists, and surgeons remain informed throughout the recovery. When care is continuous and well-documented, it’s easier to make timely adjustments and avoid setbacks.

This approach reflects a deeper shift in how cardiac care is delivered. Rather than viewing surgery as a standalone event, medical teams now operate within systems that anticipate, adapt, and support healing at every turn. The result is a more stable recovery and a smoother return to daily life, guided not just by the surgeon in the operating room but by the network supporting them.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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Lifestyle Habits to Prevent Diabetes

8/2/2024

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​Changing one’s lifestyle is a major step towards preventing type 2 diabetes, the most common form of the disease. Individuals who’re at risk of developing diabetes or already have it can adopt the following measures to prevent the disease from occurring or progressing.

Lose Excess Weight

Research has shown that people who lose weight lower their risk of developing diabetes. According to research, individuals who lose approximately 7 percent of their body weight reduced the occurrence of diabetes by almost 60 percent. The American Diabetes Association advises individuals with prediabetes (high risk of getting diabetes) to lose at least 7 to 10 percent of their body weight to stop disease progression.

Minimize Consumption of Highly Processed Foods

Highly processed foods often contain chemical preservatives, added sugars, and unhealthy fats. Examples of highly processed foods include hot dogs, sodas, chips, candy bars, and frozen desserts. Studies have revealed that consuming highly processed foods increases the risk of developing type 2 diabetes by 30 percent.

Drink Plenty of Water

It’s advisable to limit the consumption of beverages with high amounts of sugar, and instead focus on consuming lots of water. Sugary drinks, such as sweetened fruit juice and soda, have been linked to increased risk of type 2 diabetes and latent autoimmune diabetes of adults (LADA), the latter of which exhibits features of both type 1 and type 2 diabetes. On the other hand, increased water intake improves blood sugar regulation and insulin response.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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STS Holds 2024 Workshop on Robotic Cardiac Surgery

7/4/2024

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Click herA nonprofit organization representing cardiothoracic surgeons and other allied professionals, the Society of Thoracic Surgeons (STS) has successfully held a workshop on robotic cardiac surgery. On May 9 and 10, 2024, 80 surgeons from different cities in the United States received hands-on procedural experience in cardiac robotic surgeries in a realistically simulated environment.

On day one, the participants had a hands-on simulation workshop on using the latest technology and innovation, particularly in robotic mitral valve and coronary bypass procedures. During the workshop, the participants sat on consoles where they controlled the surgical robots. The workshop was helpful to beginner robotic surgical teams that are yet to build robotic programs and advanced robotic surgical teams looking to improve their current cardiac surgery robotic practice.

On day two, world-renowned robotic cardiac surgeons provided the participants with educational activities surrounding the intricate sphere of cardiothoracic surgery. The training included faculty discussions and case videos on critical topics such as patient selection, operative techniques, perioperative management, and postoperative care.e to edit.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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Major Causes of Brain Death

6/24/2024

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Brain death and brain stem death circumstances where individuals receive artificial life support from a machine but the brain no longer functions. Many causes can lead to the status, including lack of oxygen to the brain or heart attack.

The status implies that patients will not regain consciousness or breathe without support. Medical professionals diagnose the patient as legally dead with no chance of recovery. Brain death can occur when the oxygen or blood supply to the brain stops.

Cardiac arrest can cause brain death. The heart stops beating, starving the brain of oxygen. Another cause of brain death is a heart attack.

Heart attacks block the blood supply to the heart. In addition, strokes can do the same. Strokes interrupt the blood supply to their brain.

Other causes of brain death are a severe head injury, a blockage in a blood vessel, a brain hemorrhage, infections like encephalitis, or a brain tumor.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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Understanding Coronary Artery Bypass Surgery

6/5/2024

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​Coronary artery bypass surgery is a procedure that creates a new path to allow blood to flow around (bypass) a blocked or partially blocked artery in the heart. During the surgery, a healthy blood vessel is obtained from the chest or leg area and connected below the blocked heart artery to boost blood flow to the heart muscle. Also known as coronary artery bypass grafting, coronary artery bypass graft surgery, or heart bypass surgery, the surgery helps to boost the heart’s function, especially for patients who’ve suffered a heart attack or those at an increased risk of heart attack.

Blocked arteries are caused by coronary heart disease, which causes a waxy substance known as plaque to accumulate/build up inside the arteries, which play a vital role in supplying blood to the heart. When plaque accumulates, it can cause a blood clot, and if quick action is not taken, the heart muscles, which rely on the proper functioning of the artery, can begin to die. Even though coronary artery bypass surgery doesn’t cure the heart disease that causes artery blockage, it helps lower discomfort caused by shortness of breath and chest pain.

Individuals who undergo coronary artery bypass surgery include those with severe narrowing of the main heart artery and severe chest pain due to narrowing of multiple heart arteries. Others include those with a blocked heart artery, which cannot be treated using coronary angioplasty, a minimally invasive procedure that uses a catheter to widen an affected artery.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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How to Improve the Physical Comfort of Surgeons During Surgery

5/27/2024

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​Surgery is a rewarding career, but also a demanding one with many challenges. Surgical procedures often last many hours, and they can be quite physically demanding. Fortunately, surgeons can adopt several practices to improve their physical well-being and performance.

Physical stresses surgeons experience during surgical procedures include repetitive arm movements and prolonged static positions. Operating rooms may contribute to the ergonomic stress of surgery. This is because most surgical tables are not adjustable below 28.5 inches. In addition, the handles of most surgical equipment are not available in varying sizes, potentially causing physical stress for surgeons with small hands.

To reduce ergonomic stress, operating rooms should have adjustable operating tables. In addition, health care organizations can collaborate with manufacturers to make surgical equipment with ergonomic designs. Surgeons can also incorporate various forms of exercise into their daily routines to help them deal with the physical stresses of surgery. Exercises such as strength training, yoga, tai chi, and Pilates can all be beneficial.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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Heart Valve Repair or Replacement Surgery

5/13/2024

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​The heart comprises four chambers that coordinate to take in blood and pump it across the body. There are valves between these chambers that open to allow blood from one chamber to the next and close to prevent backflow. They keep blood moving forward in the heart.

Sometimes, valves become damaged due to injury or disease. Examples of conditions that affect valves are valve regurgitation (leaky valves) and valve stenosis (valve stiffness). Some of the symptoms of damaged valves are dizziness, breathing difficulty, chest pain, heart palpitations, and swelling in the abdomen, feet, and ankles.

When a valve is damaged, it must be repaired or replaced. Valve repair surgery is an open heart procedure done in a hospital’s operating room. The patient must be sedated, and surgeons open up their chest cavity to access their heart. Afterward, they repair the damaged valve by removing the calcium deposits causing stiffness, fusing separated valve leaflets, or removing weak valve leaflets. Surgeons may also patch up leaky valves if some have developed holes.

Sometimes, the valve is so damaged it has to be replaced. In that case, surgeons remove the valve and replace it with an artificial one made of animal tissue, human tissue, or plastic coated with carbon. The surgery typically takes around three hours.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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Exercises to Improve Heart Health

4/23/2024

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​The heart is a muscle that needs regular stimulation to stay healthy. Not all exercise routines are beneficial to the heart, so it's essential to familiarize yourself with the exercises that are most beneficial to your heart health.

Aerobic exercises are the best workout routines for improving heart health. They include walking, running, biking, cycling, and swimming. Aerobic exercise benefits the heart by helping lower heart rate, blood pressure, and the chances of diabetes.

Stretch, balance, and flexibility exercises like yoga and pilates also benefit the heart. While flexibility exercises do not directly impact the heart, they ensure other muscles function properly and help improve heart health.

Resistance or strength exercises also contribute to improved heart health. Resistance training involves workout routines like weightlifting or using resistance equipment like cables or bands. Similarly, squats, push-ups, and press-ups are vital aspects of resistance training. Resistance training helps strengthen the muscles, which in turn takes stress off the heart.

American Health Council’s Best in Medicine Award, Dr. Hartmuth Bittner, Sugeon

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