Treatment of Coronary Heart Disease with Minimally Invasive Surgery.

Treatment of Coronary Heart Disease with Minimally Invasive Surgery.

In 1998, most cardiac surgical practices used cardiopulmonary bypass (CPB) and cardioplegic arrest as techniques to perform coronary artery bypass grafting (CABG) (1). More than 25% of patients undergoing CABG have =1 complications (e.g., atrial fibrillation, bleeding, myocardial infarction, sternal infection, stroke, or renal failure). Although some of the morbidity of CABG is directly related to patient comorbidity factors, some of these complications are due to the current technique of CABG. The goal of minimally invasive CABG is to avoid the morbid complications of standard CPB-supported CABG. The 2 most common techniques of minimally invasive CABG are minimally invasive direct coronary artery bypass (MIDCAB) and offpump coronary artery bypass (OPCAB). For example, the median sternotomy incision is avoided in techniques that gain access to the heart via a left anterior thoracotomy (MIDCAB, Port-Access). CPB is avoided in techniques that perform coronary bypasses on a beating heart (OPCAB). In MIDCAB, both the sternotomy and CPB are avoided.

Treatment of Coronary Heart Disease with Minimally Invasive Surgery.

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