Minimally Invasive Bypass Surgery

Minimally invasive surgery refers to new procedures that allow a surgeon to repair coronary artery disease without having to use the heart lung machine. There are three main techniques including:

Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)
"Off Pump" or "Beating Heart" Coronary Artery Bypass
Robotic Assisted Coronary Artery Bypass

Minimally Invasive Direct Coronary Bypass
This procedure uses a small opening in the chest to repair blood vessels on the front of the heart. MIDCAB is has the advantage of being performed off-pump and does not require the breastbone to be cut. The small opening is advantageous in terms of short recovery time for the patient, but it provides limited access for the surgeon. Therefore, MIDCAB is used primarily for patients needing only 1 to 2 grafts on the anterior of the heart. To determine you are a candidate for MIDCAB, you should speak with a cardiac surgeon.

"Off-Pump" or "Beating Heart" surgery
This technique is similar to conventional CABG, except the heart lung machine is not used. The breastbone is hemisected to provide access to all areas of the heart, and a special instrument is then used to stabilize the heart. The surgeon will then bypass the diseased artery with harvested blood vessels (see Coronary Artery Bypass Grafting for details). Beating heart surgery can be used with patients who require 3 to 4 grafts because the surgeon is given full access to the heart. The advantages are reduced recovery time, less trauma and other complications associated with the stopping the heart. There are, however, other risks to beating heart surgery including a less ideal surgical environment. These risks must be weighed against possible benefits. You should speak with your cardiac surgeon to see if you are a candidate for beating heart surgery.

Robotic assisted coronary bypass
This procedure is another off-pump procedure that does not require sternectomy. For more information about robotic assisted coronary artery bypass grafting, please schedule an appointment with a cardiac surgeon by calling (949) 650-3350.