What It Is
What Is Minimally Invasive
Cardiac Surgery (MICS)?
MICS — also called “small-hole heart surgery” or keyhole cardiac surgery — performs the same complete open-heart operations as traditional surgery, but through a 2–3 inch incision on the right side of the chest. The sternum (breastbone) is never cut, cracked, or retracted. Full cardiac bypass is used, so results are clinically identical to open surgery — this is not a lesser procedure, it is a better one.
The surgeon operates through the small incision using long specialised instruments and a high-definition camera. MICS is technically more demanding than traditional surgery, which is why only a small number of highly specialised centres in India offer it. KG Hospital is the national pioneer — it was performing MICS at a time when most Indian hospitals had not yet started.
Patients who have MICS go home 3–5 days after surgery and are fully recovered within 3–4 weeks. For traditional open-heart surgery, those numbers are 7–10 days and 6–8 weeks.
📷
2–3"
MICS
Right chest wall — sternum intact
🖇
1 cm
Robotic
3–4 ports — smallest possible
✂
8–12"
Open Surgery
Full sternotomy — breastbone cut
Key Advantages Over Open Surgery
✓Sternum never cut — no 6–8 week bone healing
✓Hospital stay 3–5 days vs 7–10 days
✓Full recovery 3–4 weeks vs 6–8 weeks
✓Significantly less blood loss and post-op pain
✓Minimal visible scarring after healing
✓Lower infection risk — smaller wound surface area
Procedures
MICS Procedures at
KG Hospital
The following cardiac procedures are performed at KG Hospital using the MICS approach — all through a 2–3 inch incision, without sternotomy.
01
Mitral Valve Repair & Replacement
The most commonly performed MICS procedure globally. Repair is preferred wherever possible — it preserves the natural valve and avoids lifelong blood thinners.
02
Aortic Valve Replacement
Including suture-less aortic valve replacement via the Babliak technique — an India first at KGH. Biological and mechanical prosthetic valve options available.
India First
03
Double Valve Replacement (Transaxillary)
Replacement of both aortic and mitral valves simultaneously, accessed through the armpit with zero chest incision — an India first performed for the first time at KGH.
India First
04
MICS CABG & Combined Procedures
Coronary bypass surgery through a small incision. Also combined MICS mitral valve replacement + CABG in a single operation — another India first at KGH.
India First
05
ASD Closure
Surgical closure of atrial septal defect (hole in the heart) through a small right chest incision — without cutting the sternum or needing a large wound.
06
Atrial Myxoma Removal
Removal of benign cardiac tumours (myxoma) from the heart chambers through the MICS approach — precise excision with faster recovery than open surgery.
07
Awake Open Heart Surgery
India first: cardiac surgery performed while the patient is conscious under regional anaesthesia, without general anaesthesia. Eliminates general anaesthesia risks.
India First
08
Tricuspid Valve Repair
Repair of the tricuspid valve performed alongside mitral valve surgery or as a standalone MICS procedure for tricuspid regurgitation.
National Record
4 India Firsts in
Minimally Invasive Cardiac Surgery
KG Hospital was performing MICS when most Indian hospitals had not yet started. That head start produced a record of surgical firsts that no other hospital in India has matched.
1
First in India: Transaxillary Aortic & Double Valve Replacement
Both the aortic and mitral valves replaced simultaneously through an incision in the armpit (transaxillary approach) — with zero incision on the chest wall whatsoever. This technique eliminates even the small right chest incision of conventional MICS, making it among the least invasive valve replacements ever performed. First in India at KG Hospital.
2
First in India: MICS Mitral Valve Replacement Combined with CABG
Performing two cardiac operations simultaneously — mitral valve replacement and coronary artery bypass grafting — through a single small incision in one MICS procedure. Traditionally, patients needing both operations would require full open-heart surgery. KG Hospital was the first in India to accomplish both through the minimally invasive approach.
3
First in India: Awake Open Heart Surgery
Open heart surgery performed on a fully conscious patient under regional anaesthesia (thoracic epidural) without general anaesthesia. This eliminates the risks associated with general anaesthesia — particularly valuable for elderly patients, those with respiratory compromise, or patients in whom general anaesthesia carries high risk. A technically demanding first that required both surgical and anaesthetic expertise.
4
First in India: Aortic Valve Replacement via Babliak Technique
The Babliak technique uses a suture-less prosthetic valve that is deployed without sewing it into place. This significantly reduces the aortic cross-clamp time (the period during which the heart is stopped), lowers operative risk, and improves haemodynamic performance of the new valve. KG Hospital adopted and performed this European technique first in India.
Patient Assessment
Who Is Suitable for
MICS?
MICS is suitable for most patients needing valve surgery, ASD closure, or CABG. A pre-operative assessment including echocardiogram and CT determines the best approach. Even patients who may not be suitable for MICS may still be candidates for robotic cardiac surgery.
✓ Ideal Candidates
Patients needing mitral or aortic valve surgery
ASD closure or myxoma removal
Combined valve + CABG procedures
No previous right chest or cardiac surgery
Patients wanting minimal scarring and faster recovery
Good lung function and normal chest anatomy
Elderly patients avoiding sternotomy risks
→ May Need Alternative Approach
Previous right chest surgery causing dense adhesions
Severe aortic calcification requiring root work
Certain complex congenital anatomy
Emergency presentation requiring immediate wide access
Robotic cardiac surgery may still be possible
Traditional open surgery remains an excellent option
What to Expect
Your MICS Journey
at KG Hospital
1
Consultation & Assessment
Your cardiac surgeon reviews your history, echo, and CT. A teleconsultation can be arranged for patients travelling from outside Coimbatore before your in-person visit.
Day 1
2
Pre-operative Workup
Echocardiogram, cardiac CT, coronary angiogram if required, blood tests, and cardiac anaesthesia assessment. Confirms MICS suitability and determines exact incision approach.
1–2 days before admission
3
MICS Procedure
General anaesthesia or regional anaesthesia (for Awake surgery). A 2–3 inch incision on the right chest. Cardiac bypass established. Procedure performed. Incision closed. Typically 2–4 hours.
Surgery day
4
Cardiac ICU
Recovery in Cardiac ICU for 12–24 hours. Most patients are sitting up and drinking within hours. Chest drain removed the following morning in most cases.
Night of surgery
5
Ward & Discharge
Most patients move to the cardiac ward on day 1 post-surgery and are discharged on day 3–5. Full discharge summary, wound care instructions, and follow-up appointments provided.
Day 3–5
6
Recovery
Light activities from day 7. Full recovery by week 3–4. Follow-up at 2 weeks and 6 weeks. Cardiac rehabilitation available. Return to work typically 3–4 weeks post-surgery.
3–4 weeks full recovery
Comparison
MICS vs Robotic Cardiac Surgery —
Which Is Right for You?
KG Hospital offers both MICS and Robotic Cardiac Surgery — the only hospital in Coimbatore to offer both. Your surgeon will recommend the approach best suited to your anatomy, condition, and recovery priorities.
| Feature |
Robotic |
MICS |
Open Surgery |
| Incision size | <1 cm (×3–4) | 2–3 inch | 8–12 inch |
| Sternum cut? | No | No | Yes |
| Hospital stay | 2–3 days | 3–5 days | 7–10 days |
| Full recovery | 1–2 weeks | 3–4 weeks | 6–8 weeks |
| Procedure range | CABG, valve, ASD | Full range + complex combined | All procedures |
| Available in Coimbatore | KGH only | KGH only | Multiple hospitals |
Both MICS and Robotic surgery are only available at KG Hospital in Coimbatore. Read the full Robotic Cardiac Surgery page →
