PORTSMOUTH — Open-heart surgery can be alarming to consider, but a local cardiologist said there are less invasive procedures today for many patients.

The newer procedures are still surgical, but Dr. Robert Helm, a cardiologist at Portsmouth Regional Hospital said for some patients, open heart surgery, where the chest cavity is opened and in some cases, the heart removed from the body for a period, might be avoided.

February is Heart Health Awareness month, and a good time to look at how far heart surgery has come in just a few decades.

“The newer procedures are less invasive, and in some cases, can be minimally invasive,” said Helm. “While the patient is basically getting the same operation as with open heart surgery, the procedures offer a better, and faster recovery time, with less pain. As surgeons we always want to treat the full set of a disease, but always in the least invasive way. We need to look at what it is the patient needs.”

Helm said there are cases that will still require open heart surgery. He said it is when the access to the entire heart is needed for multiple procedures.

“With newer techniques, if that is not the case, we may be able to open only a part of the sternum, and do the procedure between the ribs,” said Helm. “That may be possible for cases involving the aortic valve, for bi-valve or tri-cuspid operations. Certain types of cardiac tumors may be eligible or repairing holes in the heart wall.”

Helm said he specializes in minimally invasive heart surgery, with minimum sternotomy approaches. He does a lot of repair to aortic valves and mitral valves.

“Surgery does not need to be as terrifying to patients as it once was,” said Helm. “We have done over 250 procedures using this approach in the past several years with outcomes that compare favorably to hospitals using open heart surgery for the same conditions. Portsmouth is a local leader in this area.”

Another procedure, one that is even less invasive is trans-catheter surgery. Helm said it involves valves introduced into the groin and passed up via wires to the damaged valve. Once there, the new replacement valve can be inserted inside the damaged valve, essentially replacing it.

“This is a newer procedure and for now is reserved for medium to high risk patients,” said Helm. “We began doing this with patients who we knew could not stand surgery. Then we moved to high risk and then medium risk patients.”

Helm said as trans-catheter surgery is showing success it the select group of patients, it may eventually become more readily available to patients.