{"schema_version":"bookimed.page-context.v1","id":"open-heart-surgery","url":"https://hub.bookimed.com/heart-surgery/open-heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/open-heart-surgery.json","index_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/index.json","full_dataset_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/content.json","content_revision":"source-driven-rankings-20261008","date_modified":"2026-10-08","language":"en","kind":"guide","title":"Open-heart surgery and sternotomy: procedures, alternatives and recovery","summary":"A sternotomy divides the breastbone to provide broad access to the heart. It can support complex or combined surgery. CABG, valve replacement and myectomy describe the treatment itself; they are not synonyms for the incision.","research_credit":{"name":"Yevhenii Kozlov","role":"Co-Founder of Bookimed","url":"https://us-uk.bookimed.com/ceo/kozlov/","contribution":"Research personally prepared and reviewed","assistance":"AI tools assisted source research."},"editorial_scope":"Source-based patient information; an individual treatment plan requires clinical review.","research_method":"How this guide is researched and compared Research project led by Yevhenii Kozlov . We link clinical guidance, primary studies and named hospital or offer sources beside the relevant statements. Comparisons distinguish individual operators from programme results and preserve the study population, follow-up and limitations. Prices are dated examples with their stated scope. Research and editorial preparation are separate from clinical review; no named clinician has medically reviewed this edition. Bookimed provides care coordination. Partner and reference programmes are identified from their sources; paid ordering is not used in our published-cohort comparison. Read the editorial policy .","key_takeaways":[{"label":"Broad access can enable combined treatment","text":"Surgery may address coronary arteries, valves and the aorta during the same operation when needed.","sources":["C03","C09"]},{"label":"A small incision can still use a heart-lung machine","text":"Off-pump describes support during surgery; robotic describes instruments and access.","sources":["C06"]},{"label":"Recovery depends on the operation","text":"NHS guidance describes roughly a week in hospital and two to three months for full recovery after chest-incision valve replacement.","sources":["C08"]}],"benefits":[{"text":"Sternotomy gives the team extensive access to complete the operation and manage complex anatomy or additional procedures.","sources":["C06"]}],"limitations":[{"text":"The breastbone and soft tissues need time to heal. Smaller-access alternatives may reduce selected early recovery burdens but are not suitable for every operation.","sources":["C06","C08"]}],"sections":[{"id":"benefit-balance","title":"Benefits and trade-offs","text":"Benefits and trade-offs Potential advantages Sternotomy gives the team extensive access to complete the operation and manage complex anatomy or additional procedures. Sources: Mayo Clinic: minimally invasive surgery Trade-offs and limits The breastbone and soft tissues need time to heal. Smaller-access alternatives may reduce selected early recovery burdens but are not suitable for every operation. Sources: Mayo Clinic: minimally invasive surgery · NHS: valve recovery","links":[{"label":"Mayo Clinic: minimally invasive surgery","url":"https://www.mayoclinic.org/tests-procedures/minimally-invasive-heart-surgery/about/pac-20384895"},{"label":"Mayo Clinic: minimally invasive surgery","url":"https://www.mayoclinic.org/tests-procedures/minimally-invasive-heart-surgery/about/pac-20384895"},{"label":"NHS: valve recovery","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/recovery/"}]},{"id":"terms","title":"Open-heart surgery, sternotomy and bypass: three different terms","text":"Open-heart surgery, sternotomy and bypass: three different terms A sternotomy divides the breastbone so the surgeon can reach the heart. After the operation, the bone is brought back together, usually with wires. The breastbone needs time to heal. Do not confuse coronary bypass with heart-lung bypass. CABG creates new routes around narrowed coronary arteries. Cardiopulmonary bypass is a machine supporting circulation and oxygenation during an operation. Part of the plan Examples What it tells you Operation CABG; valve repair or replacement; aortic repair Which heart problem is being treated Access Full sternotomy; partial sternotomy; an incision between the ribs How the surgeon reaches the area Heart-lung support On-pump or off-pump Whether a heart-lung machine supports circulation Sources: Heart Surgery: What to Expect During Surgery · NHS: valve types","links":[{"label":"Heart Surgery: What to Expect During Surgery","url":"https://www.nhlbi.nih.gov/health/heart-surgery/during"},{"label":"NHS: valve types","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/how-its-done/"}],"tables":[[["Part of the plan","Examples","What it tells you"],["Operation","CABG; valve repair or replacement; aortic repair","Which heart problem is being treated"],["Access","Full sternotomy; partial sternotomy; an incision between the ribs","How the surgeon reaches the area"],["Heart-lung support","On-pump or off-pump","Whether a heart-lung machine supports circulation"]]]},{"id":"operations","title":"Which operations may use an open chest?","text":"Which operations may use an open chest? The same access can be used for very different treatments. Start with the diagnosis and the exact procedure in the surgical recommendation. Procedure What the operation does Read next Coronary artery bypass grafting (CABG) Uses blood-vessel grafts to route blood around narrowed coronary arteries The CABG guide explains graft planning and alternatives Valve repair or replacement Repairs a valve or replaces it with a prosthetic valve The valve guide separates repair, replacement and catheter procedures Open aortic repair Replaces a diseased section of the aorta with a graft The aortic guide explains why the location of disease matters Maze surgery for atrial fibrillation Creates a pattern of scar tissue to interrupt abnormal electrical signals The rhythm guide distinguishes surgical and catheter ablation Advanced heart-failure operations Implants a heart-support device or replaces the heart with a donor heart The heart-failure guide explains these separate pathways Sources: Heart Surgery: Conditions Treated by Heart Surgery Coronary bypass ↗ Heart valves ↗ Aortic surgery ↗ Rhythm & Maze surgery ↗ Heart failure, LVAD & transplant ↗","links":[{"label":"Heart Surgery: Conditions Treated by Heart Surgery","url":"https://www.nhlbi.nih.gov/health/heart-surgery/types"},{"label":"Coronary bypass ↗","url":"https://hub.bookimed.com/heart-surgery/coronary-bypass/"},{"label":"Heart valves ↗","url":"https://hub.bookimed.com/heart-surgery/heart-valve-surgery/"},{"label":"Aortic surgery ↗","url":"https://hub.bookimed.com/heart-surgery/aortic-surgery/"},{"label":"Rhythm & Maze surgery ↗","url":"https://hub.bookimed.com/heart-surgery/heart-rhythm-surgery/"},{"label":"Heart failure, LVAD & transplant ↗","url":"https://hub.bookimed.com/heart-surgery/heart-failure-surgery/"}],"tables":[[["Procedure","What the operation does","Read next"],["Coronary artery bypass grafting (CABG)","Uses blood-vessel grafts to route blood around narrowed coronary arteries","The CABG guide explains graft planning and alternatives"],["Valve repair or replacement","Repairs a valve or replaces it with a prosthetic valve","The valve guide separates repair, replacement and catheter procedures"],["Open aortic repair","Replaces a diseased section of the aorta with a graft","The aortic guide explains why the location of disease matters"],["Maze surgery for atrial fibrillation","Creates a pattern of scar tissue to interrupt abnormal electrical signals","The rhythm guide distinguishes surgical and catheter ablation"],["Advanced heart-failure operations","Implants a heart-support device or replaces the heart with a donor heart","The heart-failure guide explains these separate pathways"]]]},{"id":"when-sternotomy","title":"Why might a team recommend conventional sternotomy?","text":"Why might a team recommend conventional sternotomy? The priority is to complete the required operation safely. Conventional access may be useful when the team needs to address several problems in one operation, or when the anatomy does not suit a smaller approach. For example, a valve plan may also include coronary bypass or aortic surgery. Wider access can make complex reconstruction or combined operations possible and provides room to manage bleeding or unexpected anatomy. Previous surgery and urgent disease can influence access, but neither automatically determines the incision. A planned smaller incision may be converted to sternotomy for safety. Sources: Mayo Clinic: minimally invasive surgery · Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines Repeat surgery ↗","links":[{"label":"Mayo Clinic: minimally invasive surgery","url":"https://www.mayoclinic.org/tests-procedures/minimally-invasive-heart-surgery/about/pac-20384895"},{"label":"Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/07/22/19/36/Guideline-Update-on-Indications-for-TAVI"},{"label":"Repeat surgery ↗","url":"https://hub.bookimed.com/heart-surgery/repeat-heart-surgery/"}]},{"id":"alternatives","title":"Can the same problem be treated with a smaller incision or a catheter?","text":"Can the same problem be treated with a smaller incision or a catheter? A smaller chest incision can still involve a heart-lung machine. Conversely, off-pump CABG may be performed through a sternotomy. Robot-assisted surgery describes surgeon-controlled instruments; it does not mean that the robot operates independently. Catheter treatments are a different pathway. TAVI replaces an aortic valve through a catheter; it is not a smaller-incision version of every valve operation. Whether catheter treatment, surgery or continued medical care is appropriate depends on the disease and the intended benefit. Sources: Heart Surgery: What to Expect During Surgery · Mayo Clinic: minimally invasive surgery · Transcatheter aortic valve replacement (TAVR) Minimally invasive ↗ TAVI or valve surgery ↗ Coronary bypass ↗","links":[{"label":"Heart Surgery: What to Expect During Surgery","url":"https://www.nhlbi.nih.gov/health/heart-surgery/during"},{"label":"Mayo Clinic: minimally invasive surgery","url":"https://www.mayoclinic.org/tests-procedures/minimally-invasive-heart-surgery/about/pac-20384895"},{"label":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698"},{"label":"Minimally invasive ↗","url":"https://hub.bookimed.com/heart-surgery/minimally-invasive/"},{"label":"TAVI or valve surgery ↗","url":"https://hub.bookimed.com/heart-surgery/tavi-vs-surgical-valve-replacement/"},{"label":"Coronary bypass ↗","url":"https://hub.bookimed.com/heart-surgery/coronary-bypass/"}]},{"id":"evidence","title":"Does avoiding sternotomy always improve recovery?","text":"Does avoiding sternotomy always improve recovery? Randomized trials give a more useful answer than a general promise of faster recovery. Their results depend on the operation, the patients selected and the recovery milestone measured. Randomized comparison What the study found What it does not establish UK Mini Mitral, 2023: 330 adults at 10 centres; degenerative mitral valve repair by expert surgeons Median postoperative hospital stay was 5 days after minithoracotomy versus 6 after sternotomy. Minithoracotomy did not show superiority for the primary physical-function measure at 12 weeks. One day less in hospital does not mean earlier full recovery. This was not a trial of all robotic or cardiac operations. MIST, 2026: 170 patients suitable for either approach to multivessel CABG at 7 centres At one month, small-thoracotomy CABG improved the SF-36 physical-recovery score by 2.9 points compared with sternotomy (95% confidence interval 0.3–5.5). Previous cardiac surgery, haemodynamic compromise and combined operations were excluded. No deaths or strokes through 12 months in this small trial cannot establish equal rare-event safety or long-term graft durability. Sources: UK Mini Mitral trial · JAMA (2023) · Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial Minimally invasive ↗ Coronary bypass ↗","links":[{"label":"UK Mini Mitral trial · JAMA (2023)","url":"https://jamanetwork.com/journals/jama/fullarticle/2805908"},{"label":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/"},{"label":"Minimally invasive ↗","url":"https://hub.bookimed.com/heart-surgery/minimally-invasive/"},{"label":"Coronary bypass ↗","url":"https://hub.bookimed.com/heart-surgery/coronary-bypass/"}],"tables":[[["Randomized comparison","What the study found","What it does not establish"],["UK Mini Mitral, 2023: 330 adults at 10 centres; degenerative mitral valve repair by expert surgeons","Median postoperative hospital stay was 5 days after minithoracotomy versus 6 after sternotomy. Minithoracotomy did not show superiority for the primary physical-function measure at 12 weeks.","One day less in hospital does not mean earlier full recovery. This was not a trial of all robotic or cardiac operations."],["MIST, 2026: 170 patients suitable for either approach to multivessel CABG at 7 centres","At one month, small-thoracotomy CABG improved the SF-36 physical-recovery score by 2.9 points compared with sternotomy (95% confidence interval 0.3–5.5).","Previous cardiac surgery, haemodynamic compromise and combined operations were excluded. No deaths or strokes through 12 months in this small trial cannot establish equal rare-event safety or long-term graft durability."]]]},{"id":"recovery","title":"Recovery: leaving hospital, healing and rebuilding fitness","text":"Recovery: leaving hospital, healing and rebuilding fitness These are separate milestones. After valve surgery through chest incisions, NHS guidance describes about a week in hospital and around two to three months for full recovery. These are general expectations for valve replacement, not a timetable for every open-heart operation. Recovery includes wound care, pain relief, medicines and cardiac rehabilitation. Walking ability can improve before the breastbone is ready for lifting, driving or physical work. Return travel depends on clinical recovery and continuing care at home, rather than the number of nights included in a package. Sources: NHS: valve recovery Recovery ↗ Costs & quotes ↗","links":[{"label":"NHS: valve recovery","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/recovery/"},{"label":"Recovery ↗","url":"https://hub.bookimed.com/heart-surgery/recovery/"},{"label":"Costs & quotes ↗","url":"https://hub.bookimed.com/heart-surgery/cost/"}]},{"id":"risks","title":"How to interpret open-heart surgery risks","text":"How to interpret open-heart surgery risks There is no single risk percentage for “open-heart surgery”. The operation, urgency and underlying health change the estimate. Possible complications include bleeding, infection, irregular rhythms, stroke, kidney or lung problems, and death. Smaller access does not remove the major risks of cardiac surgery. STS tools estimate operative mortality and major complications using procedure-specific patient information. A calculated estimate is one part of the clinical discussion. A hospital’s published result describes its treated population; it is not your personal probability. When a result is quoted Check this before comparing The outcome Death, stroke, infection and repeat intervention are different outcomes; “success” needs a definition. The period An in-hospital result, an operative/30-day measure and a five-year result answer different questions. The patients Separate isolated operations from combined procedures and planned cases from emergencies. The comparison Look for patient numbers, follow-up completeness and adjustment for case mix. Raw percentages can mislead. Sources: Heart Surgery: Risks · Mayo Clinic: minimally invasive surgery · STS risk calculators · STS rating methodology Compare surgeon expertise ↗ Specialists ↗","links":[{"label":"Heart Surgery: Risks","url":"https://www.nhlbi.nih.gov/health/heart-surgery/risks"},{"label":"Mayo Clinic: minimally invasive surgery","url":"https://www.mayoclinic.org/tests-procedures/minimally-invasive-heart-surgery/about/pac-20384895"},{"label":"STS risk calculators","url":"https://www.sts.org/resources/calculators-tools/sts-risk-calculators"},{"label":"STS rating methodology","url":"https://publicreporting.sts.org/acsd-exp"},{"label":"Compare surgeon expertise ↗","url":"https://hub.bookimed.com/heart-surgery/surgeon-rankings/"},{"label":"Specialists ↗","url":"https://hub.bookimed.com/heart-surgery/surgeons/"}],"tables":[[["When a result is quoted","Check this before comparing"],["The outcome","Death, stroke, infection and repeat intervention are different outcomes; “success” needs a definition."],["The period","An in-hospital result, an operative/30-day measure and a five-year result answer different questions."],["The patients","Separate isolated operations from combined procedures and planned cases from emergencies."],["The comparison","Look for patient numbers, follow-up completeness and adjustment for case mix. Raw percentages can mislead."]]]},{"id":"consultation","title":"What a complete open-heart operation can address","text":"What a complete open-heart operation can address The advantage of broad access is the ability to perform the required reconstruction, including combined work when needed. The trade-off is breastbone healing and the recovery burden of the operation. CABG reconstructs blood supply using grafts. Valve surgery repairs or replaces diseased valves. Aortic surgery reconstructs the affected artery segment. Combined operations address more than one structural problem. Sources: ACC revascularization guidance (2021) · ESC/EACTS valve guidance (2025) · ACC/AHA aortic guidance (2022) Compare clinics ↗ Recovery ↗","links":[{"label":"ACC revascularization guidance (2021)","url":"https://www.acc.org/Latest-in-Cardiology/Articles/2022/10/31/13/02/Key-Takeaways-From-the-2021-Coronary-Revascularization-Guidelines"},{"label":"ESC/EACTS valve guidance (2025)","url":"https://www.escardio.org/news/news-room/congress-news/2025-guidelines-valvular-heart-disease/"},{"label":"ACC/AHA aortic guidance (2022)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/11/01/12/21/2022-Guideline-on-Aortic-Disease-2-gl-ad"},{"label":"Compare clinics ↗","url":"https://hub.bookimed.com/heart-surgery/clinics/"},{"label":"Recovery ↗","url":"https://hub.bookimed.com/heart-surgery/recovery/"}]},{"id":"treatment-programmes","title":"Compare complete treatment programmes","text":"Compare complete treatment programmes Istanbul, Turkey Faruk Gencoglu · robotic bypass ↗ Faruk Gençoğlu Hisar Hospital Intercontinental An advertised $20,000 robotic bypass package with preoperative tests, nursing, seven hospital days, hotel accommodation and transfers. $20,000 advertised package USD · advertised offer checked 8 October 2026. An advertised named-surgeon package with explicit medical and travel services; no package-specific robotic CABG outcomes are supplied. See method, care and package ↗ Barcelona, Spain Xavier Ruyra · CABG in Barcelona ↗ Xavier Ruyra Baliarda Centro Médico Teknon CABG with a named cardiac surgeon, preoperative specialist consultations, an individual room and five hospital days in the advertised package. $41,411.97 advertised package USD · observed 8 October 2026; individual quote required. A named-surgeon CABG offer with defined medical inclusions. It supplies no package-specific outcomes cohort or comparative access-route results. See method, care and package ↗ Treatment programmes ↗","links":[{"label":"Faruk Gencoglu · robotic bypass ↗","url":"https://hub.bookimed.com/heart-surgery/programme-hisar-cabg/"},{"label":"See method, care and package ↗","url":"https://hub.bookimed.com/heart-surgery/programme-hisar-cabg/"},{"label":"Xavier Ruyra · CABG in Barcelona ↗","url":"https://hub.bookimed.com/heart-surgery/programme-teknon-cabg/"},{"label":"See method, care and package ↗","url":"https://hub.bookimed.com/heart-surgery/programme-teknon-cabg/"},{"label":"Treatment programmes ↗","url":"https://hub.bookimed.com/heart-surgery/treatment-programmes/"}]}],"introduction":"Heart surgery guide / Open-heart surgery Open-heart surgery · Decision guide Open-heart surgery and sternotomy: procedures, alternatives and recovery Find out which operation is planned, how the surgeon will reach the heart and what each choice means for recovery. Research by Yevhenii Kozlov · Co-Founder of Bookimed Updated 8 October 2026 Sources linked throughout At a glance A sternotomy divides the breastbone to provide broad access to the heart. It can support complex or combined surgery. CABG, valve replacement and myectomy describe the treatment itself; they are not synonyms for the incision. Broad access can enable combined treatment Surgery may address coronary arteries, valves and the aorta during the same operation when needed. Sources: ESC/EACTS valve guidance (2025) · ACC/AHA aortic guidance (2022) A small incision can still use a heart-lung machine Off-pump describes support during surgery; robotic describes instruments and access. Sources: Mayo Clinic: minimally invasive surgery Recovery depends on the operation NHS guidance describes roughly a week in hospital and two to three months for full recovery after chest-incision valve replacement. Sources: NHS: valve recovery","related_documents":[{"id":"heart-surgery","title":"Heart surgery abroad: treatments, clinics and costs","kind":"home","url":"https://hub.bookimed.com/heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-surgery.json"},{"id":"coronary-bypass","title":"Coronary bypass surgery (CABG): options, teams and recovery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/coronary-bypass/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/coronary-bypass.json"},{"id":"heart-valve-surgery","title":"Heart valve surgery: repair, replacement and catheter options","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/heart-valve-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-valve-surgery.json"},{"id":"minimally-invasive","title":"Minimally invasive and robotic heart surgery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/minimally-invasive/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/minimally-invasive.json"},{"id":"aortic-surgery","title":"Aortic aneurysm surgery: options and specialist teams","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/aortic-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/aortic-surgery.json"},{"id":"clinics","title":"Heart surgery clinics: compare techniques and specialist teams","kind":"directory","url":"https://hub.bookimed.com/heart-surgery/clinics/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/clinics.json"},{"id":"surgeons","title":"Find cardiac surgeons and heart specialists by procedure","kind":"surgeons","url":"https://hub.bookimed.com/heart-surgery/surgeons/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeons.json"},{"id":"cost","title":"Heart surgery costs: valve surgery and CABG quotes","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/cost/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/cost.json"},{"id":"recovery","title":"Recovery after heart surgery: hospital, home and travel","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/recovery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/recovery.json"},{"id":"heart-failure-surgery","title":"Heart failure surgery: underlying causes, LVAD and transplant","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/heart-failure-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-failure-surgery.json"},{"id":"heart-rhythm-surgery","title":"Atrial fibrillation surgery: Maze, ablation and appendage closure","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/heart-rhythm-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-rhythm-surgery.json"},{"id":"repeat-heart-surgery","title":"Repeat heart surgery: reoperation and alternative approaches","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/repeat-heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/repeat-heart-surgery.json"},{"id":"surgeon-rankings","title":"Heart surgeon rankings by reported experience, method and results","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/surgeon-rankings/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeon-rankings.json"},{"id":"tavi-vs-surgical-valve-replacement","title":"TAVI vs surgical aortic valve replacement: suitability, risks and lifetime planning","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/tavi-vs-surgical-valve-replacement/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/tavi-vs-surgical-valve-replacement.json"},{"id":"treatment-programmes","title":"Heart surgery treatment programmes: doctors, packages and costs","kind":"treatment-listing","url":"https://hub.bookimed.com/heart-surgery/treatment-programmes/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/treatment-programmes.json"},{"id":"programme-hisar-cabg","title":"Hisar robotic coronary bypass package: surgeon, care and $20,000 price","kind":"treatment-programme","url":"https://hub.bookimed.com/heart-surgery/programme-hisar-cabg/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/programme-hisar-cabg.json"},{"id":"programme-teknon-cabg","title":"Xavier Ruyra at Teknon: coronary bypass package and cost","kind":"treatment-programme","url":"https://hub.bookimed.com/heart-surgery/programme-teknon-cabg/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/programme-teknon-cabg.json"}],"sources":{"C01":{"id":"C01","title":"Key Takeaways From the 2021 Coronary Revascularization Guidelines","url":"https://www.acc.org/Latest-in-Cardiology/Articles/2022/10/31/13/02/Key-Takeaways-From-the-2021-Coronary-Revascularization-Guidelines","publisher":"American College of Cardiology","published":"2022-10-31","read_at":"2026-10-07","source_type":"Professional society expert analysis of guideline"},"C03":{"id":"C03","title":"2025 ESC/EACTS Guidelines for the management of valvular heart disease","url":"https://www.escardio.org/news/news-room/congress-news/2025-guidelines-valvular-heart-disease/","publisher":"European Society of Cardiology","published":"2025","read_at":"2026-10-07","source_type":"Official guideline release overview"},"C04":{"id":"C04","title":"How a heart valve replacement is done","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/how-its-done/","publisher":"NHS","published":"2025-07-17 (review)","read_at":"2026-10-08","source_type":"National health service patient information","body_access":"full_public_page_read","support_location":"Types of replacement heart valve; Open heart surgery; Minimally invasive surgery; TAVI steps","interpretation_limit":"Used for procedure and prosthesis descriptions only. Its TAVI candidacy wording is narrower than 2025 ESC/EACTS; do not use it to restrict TAVI to high-risk/inoperable patients."},"C05":{"id":"C05","title":"Minithoracotomy vs Conventional Sternotomy for Mitral Valve Repair: A Randomized Clinical Trial","url":"https://jamanetwork.com/journals/jama/fullarticle/2805908","publisher":"JAMA","published":"2023-06-13","read_at":"2026-10-08","source_type":"Primary randomized clinical trial; saved article excerpts","body_access":"saved_primary_article_excerpts","support_location":"Methods/Results; Primary Outcome; Table 3; postoperative length of stay"},"C06":{"id":"C06","title":"Minimally invasive heart surgery","url":"https://www.mayoclinic.org/tests-procedures/minimally-invasive-heart-surgery/about/pac-20384895","publisher":"Mayo Clinic","published":"2025-12-30","read_at":"2026-10-08","source_type":"Hospital patient information","body_access":"full_public_page_read","support_location":"Overview; Why it is done; Risks; During; Robot-assisted heart surgery"},"C08":{"id":"C08","title":"Recovering from a heart valve replacement","url":"https://www.nhs.uk/tests-and-treatments/heart-valve-replacement/recovery/","publisher":"NHS","published":"2025-07-17 (review)","read_at":"2026-10-08","source_type":"National health service patient information","body_access":"full_public_page_read","support_location":"How to recover; Recovering in hospital; Recovering at home"},"C09":{"id":"C09","title":"2022 ACC/AHA Aortic Disease Guideline Key Perspectives: Part 2 of 2","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/11/01/12/21/2022-Guideline-on-Aortic-Disease-2-gl-ad","publisher":"American College of Cardiology","published":"2022-11-02","read_at":"2026-10-07","source_type":"Official society guideline summary"},"C11":{"id":"C11","title":"STS Risk Calculators","url":"https://www.sts.org/resources/calculators-tools/sts-risk-calculators","publisher":"Society of Thoracic Surgeons","published":null,"read_at":"2026-10-08","source_type":"Registry owner's tool description","body_access":"full_public_page_read","support_location":"Adult Cardiac Risk Calculators: ACSD Operative Risk Calculator and procedure-specific calculators"},"C13":{"id":"C13","title":"Explanation of STS Adult Cardiac Surgery Database Ratings","url":"https://publicreporting.sts.org/acsd-exp","publisher":"Society of Thoracic Surgeons","published":null,"read_at":"2026-10-08","source_type":"Registry methodology","body_access":"full_public_page_read","support_location":"Risk Adjustment; Composite quality ratings, patient populations and reporting periods"},"cabg-mist170":{"id":"cabg-mist170","title":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/","doi":"10.1016/S0140-6736(26)01288-2","publication_year":2026,"source_kind":"primary_multicentre_randomized_trial","body_access":"complete_original_abstract_read_via_Europe_PMC","support_location":"Methods and Findings; July31 online/August22 print2026","short_excerpt":"The primary endpoint was patient-reported physical recovery at 1 month","read_at":"2026-10-08","source_type":"primary_multicentre_randomized_trial","body_file":"sources/mist.json","access_limit":"Publisher full article is subscription-only; only original abstract used. No claims about unreported subgroup outcomes or long-term graft patency."},"ax-nih-during":{"id":"ax-nih-during","title":"Heart Surgery: What to Expect During Surgery","url":"https://www.nhlbi.nih.gov/health/heart-surgery/during","publisher":"NHLBI, NIH","published":"2022-06-01","read_at":"2026-10-08","source_type":"Government patient information","source_kind":"Government patient information","body_access":"full_public_page_read","support_location":"Open-heart surgery; Off-pump heart surgery; Minimally invasive heart surgery"},"ax-nih-types":{"id":"ax-nih-types","title":"Heart Surgery: Conditions Treated by Heart Surgery","url":"https://www.nhlbi.nih.gov/health/heart-surgery/types","publisher":"NHLBI, NIH","published":"2022-06-01","read_at":"2026-10-08","source_type":"Government patient information","source_kind":"Government patient information","body_access":"full_public_page_read","support_location":"Aneurysm; Atrial fibrillation; Coronary heart disease; Heart failure; Heart valve disease","body_file":"sources/nih-types.html"},"ax-nih-risks":{"id":"ax-nih-risks","title":"Heart Surgery: Risks","url":"https://www.nhlbi.nih.gov/health/heart-surgery/risks","publisher":"NHLBI, NIH","published":"2022-06-01","read_at":"2026-10-08","source_type":"Government patient information","source_kind":"Government patient information","body_access":"full_public_page_read","support_location":"Complication list and factors associated with higher risk"},"ax-mayo-tavi":{"id":"ax-mayo-tavi","title":"Transcatheter aortic valve replacement (TAVR)","url":"https://www.mayoclinic.org/tests-procedures/transcatheter-aortic-valve-replacement/about/pac-20384698","publisher":"Mayo Clinic","published":"2025-08-12","read_at":"2026-10-08","source_type":"Hospital patient information","source_kind":"Hospital patient information","body_access":"full_public_page_read","support_location":"Overview; Risks; During; After","access_limit":"Used for technique, risks and follow-up, not current guideline age thresholds."},"ax-acc-tavi2020":{"id":"ax-acc-tavi2020","title":"Update on TAVI Indications From 2020 ACC/AHA Valvular Guidelines","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/07/22/19/36/Guideline-Update-on-Indications-for-TAVI","publisher":"American College of Cardiology","published":"2021-07-22","read_at":"2026-10-08","source_type":"Official society guideline summary","source_kind":"Official society guideline summary","body_access":"full_public_page_read","support_location":"Points 1, 7–8: anatomy, excluded trial populations and concomitant disease","access_limit":"The page’s 5-year durability horizon is outdated; not used for current long-term evidence."},"ax-esc2025-release":{"id":"ax-esc2025-release","title":"2025 ESC/EACTS Guidelines for the management of valvular heart disease: official release","url":"https://www.escardio.org/news/news-room/congress-news/2025-guidelines-valvular-heart-disease/","publisher":"European Society of Cardiology","published":"2025-08-29","read_at":"2026-10-08","source_type":"Official guideline release overview","source_kind":"Official guideline release overview","body_access":"full_public_page_read","support_location":"Aortic stenosis: age 70, tricuspid valve, suitable anatomy, younger patients, lifetime trajectory","access_limit":"Overview is kept separate from the recovered full guideline."},"pd-adult-mist170":{"title":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.","publisher":"Lancet (London, England)","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/mist170.json","published_at":"2026-07-31","doi":"10.1016/s0140-6736(26)01288-2","authors":"Ruel M, Nambala S, Guo MH, Verevkin A, Rabindranauth P, Kikuchi K, Davierwala PM, Lemma M, Ponnambalam M, Sheikh A, Black A, Borger MA, Whitlock RP, Zhang Y, Wells GA."}}}