Closed heart surgery refers to cardiac surgical procedures that can be performed without opening the heart chambers and without the need for cardiopulmonary bypass (heart-lung bypass). The surgeon operates on the exterior of the heart or great vessels while the heart continues to beat normally, without stopping it or entering its interior.
The term ‘closed heart’ is used to distinguish these procedures from open heart operations, where the heart is stopped and entered using bypass support. Common examples include patent ductus arteriosus (PDA) ligation (surgically tying off the abnormal vessel), coarctation of the aorta repair (resection and reconstruction of the narrowed aortic section), and pericardial drainage procedures. The heart functions throughout these operations.
Modern closed heart surgery also encompasses a growing range of video-assisted thoracoscopic (VATS) and robotic techniques, where very small incisions and camera-guided instruments allow surgeons to operate with minimal trauma to the chest wall. Many procedures that previously required full sternotomy (splitting the breastbone) can now be performed as minimally invasive closed procedures.
Closed heart procedures generally involve less physiological disturbance and faster recovery than open heart surgery, as they avoid the inflammatory response associated with cardiopulmonary bypass and do not require the heart to be arrested. However, the range of cardiac conditions that can be addressed without entering the heart chambers is necessarily limited.
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