Less invasive heart bypass surgery just as good as traditional method, Canadian-led study finds

A new Canadian-led study has found that a minimally invasive technique to perform bypass surgery — the most common heart surgery in the world — is as safe as the standard procedure that has been carried out for decades.

The study, published in The Lancet medical journal on Friday, also showed patients who underwent the less invasive procedure for multiple blocked arteries recovered faster than their counterparts who got the traditional one.

“It’s the first time that any form of minimal[ly] invasive heart surgery is actually shown to be as good and even better than … the classic way of doing it,” said Dr. Marc Ruel, a cardiac surgeon at the University of Ottawa Heart Institute, who led the research.

Medical teams performed both types of surgeries during a randomized trial involving 170 heart bypass patients in six different countries, including Canada, between 2018 and 2024.

During a traditional bypass surgery, which is performed to treat symptoms of coronary artery disease, a doctor opens up a patient’s chest by cutting through their breastbone. This procedure has been used for almost 60 years, the study says.

For the less invasive procedure, a five- to seven-centimetre incision is made on the side of the chest, resulting in a smaller scar.

The study found patients who had the less invasive procedure needed fewer blood transfusions and spent less time on a breathing machine than those who had the traditional surgery.

Pain and time spent in hospital were similar between the two groups of patients, the study found.

“Bypass surgery is a robust, very durable, very effective operation, but it is so incredibly invasive. And that’s what we wanted to tackle,” Ruel told CBC News.

Cardiac surgery ‘a bit late to the party’

About 15,000 people undergo heart bypass surgery every year in Canada, according to a 2021 study published in the Canadian Medical Association Journal.

But cardiac surgery has been “a bit late to the party” in using minimally invasive options when compared to other fields, said Dr. Stephen Fremes, a staff surgeon at Sunnybrook Health Sciences Centre in Toronto. Such options began to be developed in the 1990s.

Fremes, who wasn’t involved in the study, said while some questions persist, the findings demonstrate a less invasive option exists.

“It doesn’t mean that it’s ready for prime time, but it does show that it is possible,” he told CBC News. “And it does show that in centres where there is one or more surgeons that are dedicated to learning these procedures, that it is possible. “

That was echoed by Ruel, who acknowledged the less invasive surgery isn’t for every patient.

“Safety and efficacy always have to be the key priorities, not the type of incision that you have,” he said.

But for patients like Diana Wilkinson, who had the less invasive surgery at the University of Ottawa Heart Institute in 2018, the procedure has been “a success story.”

About a month after the operation, she travelled to Nicaragua. Within two years, she was climbing Kilimanjaro, the highest mountain in Africa.

“It was actually a very … simple process that I underwent,” she said. “Overall, I couldn’t have been happier and more grateful.”