Minimally invasive cardiac surgery: Reduced recovery time
Minimally invasive cardiac surgery, also known as keyhole cardiac surgery, uses small incisions in the chest and endoscopic instruments to gain access to the heart. PHOTO: GETTY IMAGES
BRANDED CONTENT Minimally invasive cardiac surgery: How open heart bypass alternative reduces recovery time with smaller incisions The procedure, performed at Singapore's Mount Elizabeth Hospitals, offers patients a gentler treatment option with less physical trauma
At 77, Mr Chua Wan Chuan looked like the picture of health. He kept active with daily walks, was feeling good and showed no signs of heart trouble. So, when a routine health screening revealed severe blockages in his main arteries, it came as a shock.
Says Mr Chua: 'When I first got the news, I was really worried. I didn't know what to do or what choices I had. The doctor said I might need an open heart bypass surgery, and that made me very uneasy – it just sounded too risky for someone my age.'
'That was a terrifying moment for us,' recalls his daughter Ms Michelle Chua, 44, an accountant. 'It is a major surgery, and even though my dad was healthy, I worried about complications and the long recovery ahead.'
Traditionally, an open heart bypass surgery involves a large incision across the chest to access the heart – an option Mr Chua was not comfortable with. Angioplasty with stenting was a possible alternative. However, due to the presence of heavily calcified blockages in all of Mr Chua's three major arteries, his cardiologist, Dr Lim Tai Tian at Mount Elizabeth Hospitals, cautioned against it. The long-term risks of repeat procedures and higher mortality made an open heart bypass surgery the better choice.
Then came a glimmer of hope: minimally invasive cardiac surgery (MICS).
Cardiologist Dr Lim Tai Tian from Mount Elizabeth Hospitals introduced Mr Chua Wan Chuan to the minimally invasive cardiac surgery.
PHOTO: MOUNT ELIZABETH HOSPITALS
What is minimally invasive cardiac surgery
MICS, also known as keyhole cardiac surgery, uses small incisions in the chest and endoscopic instruments (thin, flexible tubes with a camera and light) to gain access to the heart.
Mr Chua, who had originally been slated for an open heart bypass surgery, was identified as a suitable candidate for this surgery.
'When we got the green light, my dad was relieved,' says his daughter. 'He was thrilled that he could have the bypass without the trauma of a major chest operation.'
Mr Chua, who had originally been slated for an open heart bypass surgery, was identified as a suitable candidate for the minimally invasive cardiac surgery surgery.
PHOTO: MOUNT ELIZABETH HOSPITALS
The surgery was carried out by Professor Theodoros Kofidis, a cardiothoracic surgeon at Mount Elizabeth Hospitals, Singapore, who has specialised in MICS for over 10 years.
'Mr Chua was a suitable candidate for MICS,' says Prof Kofidis. 'He is not obese, had a healthy chest size for his heart, no major calcium build-up in his aorta, and his heart's condition and function were within a good range.'
Not everyone qualifies for MICS. According to Prof Kofidis, patients with severe obesity, poor heart function, multiple valve issues, have had past radiotherapy to the left side of their chest, or very high lung blood pressure are not suitable.
'For MICS, about 50 to 60 per cent of patients qualify. In Asia, factors like smaller, flatter chest anatomy can be a limiting factor,' he explains.
Mr Chua's surgery was carried out by Professor Theodoros Kofidis, a cardiothoracic surgeon with over a decade of experience in minimally invasive cardiac surgery.
PHOTO: MOUNT ELIZABETH HOSPITALS
Mr Chua's keyhole cardiac surgery went smoothly a few months ago. He recalls: 'On the second day, I was able to walk; then on the fifth day, I climbed the stairs. I was discharged within a week.'
Adds Ms Chua: 'Initially, my dad walked slower and he was concerned he wouldn't be able to walk as fast as before, but he kept walking daily, slowly but steadily. Weeks later, he was back to his normal self, walking at the same speed as he did before the surgery.'
What is minimally invasive cardiac surgery?
Professor Theodoros Kofidis, a cardiothoracic surgeon at Singapore's Mount Elizabeth Hospitals, has been performing minimally invasive cardiac surgery (MICS) since 2009.
The first MICS bypass surgery was performed by Argentinian professor Federico Benetti in the late 1970s. It was used more widely in the 1990s, and was largely adopted in the US and Canada.
MICS uses smaller incisions so there is less trauma to the body, reduced blood loss and a lower risk of infection. Because the chest cavity remains intact, there is increasing evidence that suggests lung function recovers more effectively, too.
In general, patients can resume their full daily activities within three weeks, compared with a recovery time of more than three months after an open heart bypass surgery.
Why cardiac screening is important
Like Mr Chua, many patients may not be aware that they have heart issues until they go for a screening.
Says Dr Lim: 'Having no symptoms doesn't mean you don't have any underlying cardiac disease. Women, in particular, often don't have any symptoms. They don't complain of chest pain or shortness of breath. And they just feel tired. Some of them don't even feel tired. For men, most of them have chest pain or shortness of breath.'
He remembers spotting very abnormal heart readings during Mr Chua's treadmill test. This led him to order more tests – a CT (computed tomography) scan to check for calcium build-up in the arteries, and an angiogram to see how badly the three main arteries were blocked.
As part of the screening procedure, it is also important to ask questions to identify cardiac risk factors, says Dr Lim. These include age, whether one smokes or has smoked; has diabetes, high blood pressure or high cholesterol; whether they exercise; and have a family history of heart disease or stroke.
For example, if a family member had a heart problem at a young age, such as in his or her 50s, then other family members in their 40s are already at risk, Dr Lim notes. Diabetes will also increase one's risk of heart disease by four to eight times. 'So if you wait for the symptoms, it might be too late,' he adds.
Beyond MICS, the experienced team of cardiologists at Mount Elizabeth Hospitals uses current technologies for complex angioplasty procedures. These include imaging tools to see inside the arteries more clearly as well as balloon devices that use shock waves to break up hardened deposits so stents can be placed more safely and effectively.
The heart-team approach between Dr Lim and Prof Kofidis as seen in Mr Chua's case is a common practice at Mount Elizabeth Hospitals. Whether treating straightforward cases or tackling complex heart conditions, such collaboration supports coordinated and effective patient care.
To learn more about how you can manage challenging medical conditions, visit Mount Elizabeth's hub of resources.
Join ST's WhatsApp Channel and get the latest news and must-reads.
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Straits Times
13-05-2025
- Straits Times
Minimally invasive cardiac surgery: Reduced recovery time
Minimally invasive cardiac surgery, also known as keyhole cardiac surgery, uses small incisions in the chest and endoscopic instruments to gain access to the heart. PHOTO: GETTY IMAGES BRANDED CONTENT Minimally invasive cardiac surgery: How open heart bypass alternative reduces recovery time with smaller incisions The procedure, performed at Singapore's Mount Elizabeth Hospitals, offers patients a gentler treatment option with less physical trauma At 77, Mr Chua Wan Chuan looked like the picture of health. He kept active with daily walks, was feeling good and showed no signs of heart trouble. So, when a routine health screening revealed severe blockages in his main arteries, it came as a shock. Says Mr Chua: 'When I first got the news, I was really worried. I didn't know what to do or what choices I had. The doctor said I might need an open heart bypass surgery, and that made me very uneasy – it just sounded too risky for someone my age.' 'That was a terrifying moment for us,' recalls his daughter Ms Michelle Chua, 44, an accountant. 'It is a major surgery, and even though my dad was healthy, I worried about complications and the long recovery ahead.' Traditionally, an open heart bypass surgery involves a large incision across the chest to access the heart – an option Mr Chua was not comfortable with. Angioplasty with stenting was a possible alternative. However, due to the presence of heavily calcified blockages in all of Mr Chua's three major arteries, his cardiologist, Dr Lim Tai Tian at Mount Elizabeth Hospitals, cautioned against it. The long-term risks of repeat procedures and higher mortality made an open heart bypass surgery the better choice. Then came a glimmer of hope: minimally invasive cardiac surgery (MICS). Cardiologist Dr Lim Tai Tian from Mount Elizabeth Hospitals introduced Mr Chua Wan Chuan to the minimally invasive cardiac surgery. PHOTO: MOUNT ELIZABETH HOSPITALS What is minimally invasive cardiac surgery MICS, also known as keyhole cardiac surgery, uses small incisions in the chest and endoscopic instruments (thin, flexible tubes with a camera and light) to gain access to the heart. Mr Chua, who had originally been slated for an open heart bypass surgery, was identified as a suitable candidate for this surgery. 'When we got the green light, my dad was relieved,' says his daughter. 'He was thrilled that he could have the bypass without the trauma of a major chest operation.' Mr Chua, who had originally been slated for an open heart bypass surgery, was identified as a suitable candidate for the minimally invasive cardiac surgery surgery. PHOTO: MOUNT ELIZABETH HOSPITALS The surgery was carried out by Professor Theodoros Kofidis, a cardiothoracic surgeon at Mount Elizabeth Hospitals, Singapore, who has specialised in MICS for over 10 years. 'Mr Chua was a suitable candidate for MICS,' says Prof Kofidis. 'He is not obese, had a healthy chest size for his heart, no major calcium build-up in his aorta, and his heart's condition and function were within a good range.' Not everyone qualifies for MICS. According to Prof Kofidis, patients with severe obesity, poor heart function, multiple valve issues, have had past radiotherapy to the left side of their chest, or very high lung blood pressure are not suitable. 'For MICS, about 50 to 60 per cent of patients qualify. In Asia, factors like smaller, flatter chest anatomy can be a limiting factor,' he explains. Mr Chua's surgery was carried out by Professor Theodoros Kofidis, a cardiothoracic surgeon with over a decade of experience in minimally invasive cardiac surgery. PHOTO: MOUNT ELIZABETH HOSPITALS Mr Chua's keyhole cardiac surgery went smoothly a few months ago. He recalls: 'On the second day, I was able to walk; then on the fifth day, I climbed the stairs. I was discharged within a week.' Adds Ms Chua: 'Initially, my dad walked slower and he was concerned he wouldn't be able to walk as fast as before, but he kept walking daily, slowly but steadily. Weeks later, he was back to his normal self, walking at the same speed as he did before the surgery.' What is minimally invasive cardiac surgery? Professor Theodoros Kofidis, a cardiothoracic surgeon at Singapore's Mount Elizabeth Hospitals, has been performing minimally invasive cardiac surgery (MICS) since 2009. The first MICS bypass surgery was performed by Argentinian professor Federico Benetti in the late 1970s. It was used more widely in the 1990s, and was largely adopted in the US and Canada. MICS uses smaller incisions so there is less trauma to the body, reduced blood loss and a lower risk of infection. Because the chest cavity remains intact, there is increasing evidence that suggests lung function recovers more effectively, too. In general, patients can resume their full daily activities within three weeks, compared with a recovery time of more than three months after an open heart bypass surgery. Why cardiac screening is important Like Mr Chua, many patients may not be aware that they have heart issues until they go for a screening. Says Dr Lim: 'Having no symptoms doesn't mean you don't have any underlying cardiac disease. Women, in particular, often don't have any symptoms. They don't complain of chest pain or shortness of breath. And they just feel tired. Some of them don't even feel tired. For men, most of them have chest pain or shortness of breath.' He remembers spotting very abnormal heart readings during Mr Chua's treadmill test. This led him to order more tests – a CT (computed tomography) scan to check for calcium build-up in the arteries, and an angiogram to see how badly the three main arteries were blocked. As part of the screening procedure, it is also important to ask questions to identify cardiac risk factors, says Dr Lim. These include age, whether one smokes or has smoked; has diabetes, high blood pressure or high cholesterol; whether they exercise; and have a family history of heart disease or stroke. For example, if a family member had a heart problem at a young age, such as in his or her 50s, then other family members in their 40s are already at risk, Dr Lim notes. Diabetes will also increase one's risk of heart disease by four to eight times. 'So if you wait for the symptoms, it might be too late,' he adds. Beyond MICS, the experienced team of cardiologists at Mount Elizabeth Hospitals uses current technologies for complex angioplasty procedures. These include imaging tools to see inside the arteries more clearly as well as balloon devices that use shock waves to break up hardened deposits so stents can be placed more safely and effectively. The heart-team approach between Dr Lim and Prof Kofidis as seen in Mr Chua's case is a common practice at Mount Elizabeth Hospitals. Whether treating straightforward cases or tackling complex heart conditions, such collaboration supports coordinated and effective patient care. To learn more about how you can manage challenging medical conditions, visit Mount Elizabeth's hub of resources. Join ST's WhatsApp Channel and get the latest news and must-reads.
Straits Times
12-05-2025
- Straits Times
‘We thought we were going to lose Mum': Why those over 60 need to take this common virus seriously
Symptoms of the respiratory syncytial virus may begin with a runny nose, sore throat and fever. PHOTO: GETTY IMAGES BRANDED CONTENT 'We thought we were going to lose Mum': Why those over 60 need to take this common virus seriously Respiratory syncytial virus often mimics a common cold, but in older adults, this contagious virus can quickly lead to severe infections that may require hospitalisation and ICU admission Ms Mary Chua (not her real name) vividly remembers the sight of her 95-year-old mother in the hospital, hooked up to various machines. It all started like a typical flu – just a cough. But things took a turn for the worse within days. The cough led to wheezing, then breathlessness. Even with her nursing background, Ms Chua, 69, found herself at a complete loss. Hospital tests eventually revealed that her 95-year-old mother Jane Tan (not her real name) had respiratory syncytial virus (RSV). 'She couldn't breathe at all,' recalls Ms Chua. 'I had to tell my sister in the US to come back, because we thought we were going to lose mum.' According to Dr Lee Tau Hong, an infectious disease specialist at Infectious Diseases Care Clinic in Singapore, RSV is a common, highly contagious virus that usually causes mild symptoms in healthy individuals2,6 'However, in older adults and adults living with certain underlying conditions, RSV can cause severe illness such as pneumonia and cardiac complications7.' According to the World Health Organisation (WHO), there is no specific treatment for RSV8. Madam Tan, who has a history of bronchitis, pneumonia, a heart issue and dementia, developed a severe RSV infection. She was hospitalised for 15 days in September last year. Dr Lee notes that RSV infections that need hospitalisation tend to lead to more serious outcomes than influenza cases4. 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Due to her mother's condition, Ms Chua has taken a step back from full-time work and now divides her time between caregiving and volunteering at a church. It has been difficult seeing her mother's health decline significantly these past seven months. 'When my mother was hospitalised due to RSV, I truly thought I was going to lose her and it was a devastating time for our family,' says Ms Chua. 'We used to do word search and jigsaw puzzles together and visit shopping centres – but not anymore. Her cognitive and physical abilities have declined, and her dementia has worsened. 'As a caregiver, watching a loved one struggle with RSV is incredibly challenging. The challenge goes beyond the illness itself – it is the sleepless nights, the constant worry and the disruption to daily life,' she added. Spotting the signs of RSV According to WHO, RSV symptoms include runny nose, sore throat, headache, cough, shortness of breath, fast breathing, bronchospasm (tightened airways) and wheezing8. The patient may also have other symptoms such as congestion, sneezing, difficulty breathing and cyanosis (bluish colouring of the skin due to lack of oxygen)5. Therefore, individuals are advised to consult a healthcare professional the moment symptoms appear, even if they seem mild7. Similar to other respiratory infections such as influenza and Covid-19, RSV is transmitted by tiny droplets expelled from a cough or sneeze10. Protecting loved ones involves many of the same hygiene protocols adopted during the Covid-19 pandemic: regular handwashing, disinfecting surfaces, avoiding face-touching and masking up when unwell10. Notes Dr Lee: 'RSV poses a significant burden on patients, their families and healthcare systems worldwide. As a healthcare provider, I see firsthand how severe RSV infections can be, particularly for older adults, and those with underlying health conditions. It not only causes distress for patients but also places immense strain on resources during peak flu and RSV seasons.' 'Addressing this burden through prevention, early detection and education is critical to safeguarding public health and reducing the impact of RSV on our communities,' he adds. 'When my mother was hospitalised due to RSV, I realised how vulnerable we all are to this virus. The financial strain is just as overwhelming as the emotional toll. Hospital bills, medication costs and the possibility of long-term care can quickly add up, leaving families financially drained on top of the stress of caring for a loved one,' shares Ms Chua. How RSV affects Singaporeans In Singapore, RSV tests are only administered when patients are hospitalised with severe symptoms, though some general practitioners may also offer testing4. While RSV can affect individuals of all ages, detection is especially crucial for older adults as they may have weakened immunity and pre-existing chronic conditions11. According to a study conducted in Singapore, one in every 20 older adults aged 65 years and above tested positive for RSV12. Preventive measures such as spotting the signs of RSV, good hygiene practices, taking steps for cleaner air, wearing of masks and RSV vaccinations can reduce the virus' impact on older adults. PHOTO: GETTY IMAGES According to IQVIA, a global healthcare consultancy, there were an estimated 3,251 RSV hospitalisations in Singapore in 2023, with an average cost of $9,430 per patient aged 60 or over13. A recent Singapore study published this year showed that half of all adult hospitalised RSV patients incurred hospitalisation costs of at least $3,358, while 25 per cent incurred at least $6,2814. Older adults are at a higher risk of being ill from RSV due to a decline in immunity, ageing lungs and other health conditions such as chronic obstructive pulmonary disease, asthma and heart failure2,11. These factors increase the likelihood of complications that may lead to hospitalisations, ICU admissions and exacerbation of underlying chronic medical conditions – all of which add to the hospitalisation costs. A study has shown that older adults aged 60 years and above who are hospitalised due to RSV reported a decline in physical function, with approximately a third of them demonstrating persistent decline at six months post discharge14. In another study, up to 25 per cent of older adults hospitalised due to RSV ended up requiring professional home care and 26 per cent had to be re-admitted to the hospital three months after being discharged15. Thus, in addition to ensuring any chronic underlying medical conditions are optimally managed, preventive measures such as spotting the signs of RSV, good hygiene practices, taking steps for cleaner air, wearing of masks and RSV vaccinations can reduce the virus' impact on older adults10. If you or a loved one is over 60, please speak with your doctor about RSV and its preventive measures, as well as your underlying medical issues, if any. Learn more about RSV here. Footnotes: 1 Tseng HF;The Journal of Infectious Diseases;2020;222;1298-1310 2 Kaler J;Cureus;2023;15;1-17 3 CDC. Respiratory Syncytial Virus Infection (RSV) About RSV. Last Accessed: April 2025 4 Wee LE;Lancet Reg Health West Pac; 2025;55;1-12 5 Curran D;Influenza Other Respir Viruses;2022;16;462-473 6 CDC. Respiratory Syncytial Virus Infection (RSV) Symptoms and Care. Last Assessed: April 2025 7 American Lung Association. RSV in Adults. Last Accessed: April 2025 8 WHO;Respiratory syncytial virus (RSV);2025;1-8. Last Accessed: April 2025 9 Kodama F;Infect Dis Clin North Am;2017;31;767-790 10 CDC. Respiratory Syncytial Virus Infection (RSV) How RSV spreads. Last Accessed: April 2025 11 Branche AR;Drugs & aging;2015;32;261-9, (KC) 12 Ang LW;Influenza Other Respi Viruses;2020;14;412–419 13 IQVIA;2024;1-35;Economic Burden of RSV Infection Among Older Adults in Select APEC Countries 14 Branche AR;Influenza Other Respir Viruses;2022;1-10 15 Falsey AR;Open Forum Infect Dis;2021;8;1-11 This advertorial is meant for disease awareness and educational purposes only, and does not endorse, make reference to and/or recommend any product. Speak to your healthcare professional to learn more about treatment options and prevention methods. Information in this article is valid as of May 13, 2025. If you are over 60 and have chronic conditions, speak to your doctor about respiratory syncytial virus and how to prevent it. For reporting of adverse events, write to This article references information from external websites rather than GSK being the original source of that content. ©2025 GSK group of companies or its licensor. NP-SG-RVU-ADVR-250001 April 2025 Join ST's WhatsApp Channel and get the latest news and must-reads.
Straits Times
25-04-2025
- Straits Times
Khoo Teck Puat Hospital among employers lauded for fostering workplace mental well-being
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