<P> The procedure is typically performed because of coronary artery disease (CAD), in which a plaque - like substance builds up in the coronary artery, the main pathway carrying oxygen - rich blood to the heart . This can cause a blockage and / or a rupture, which can lead to a heart attack . </P> <P> As an alternative to open heart surgery, which involves a five - to eight - inch incision in the chest wall, a surgeon may perform an endoscopic procedure by making very small incisions through which a camera and specialized tools are inserted . </P> <P> In robot - assisted heart surgery, a machine controlled by a cardiac surgeon is used to perform a procedure . The main advantage to this is the size of the incision required: three small holes instead of an incision big enough for the surgeon's hands . </P> <P> As with any surgical procedure, cardiac surgery requires postoperative precautions to avoid complications . Incision care is needed to avoid infection and minimize scarring . Swelling and loss of appetite are common . </P>

When was the first open heart surgery done