What is minimally-invasive coronary bypass surgery?

Minimally-invasive coronary artery bypass surgery, also known as beating-heart surgery, is a less invasive alternative to coronary artery bypass graft surgery (CABG). Minimally invasive bypass surgery can improve blood flow to the heart without the potential complications, necessity of using of the heart-lung bypass machine and extended recovery time associated with traditional CABG surgery.

Types of minimally invasive coronary bypass surgery

Beating heart surgery is performed while your heart is still beating — you don’t need the assistance of a heart-lung bypass machine. There are two types of minimally invasive coronary artery bypass surgery:

Minimally invasive direct coronary artery bypass (MIDCAB)
If your doctor recommends MIDCAB surgery for you, you will not need the help of a heart-lung bypass machine to keep your heart beating during the procedure. Your doctor will also cut smaller incisions in the chest to gain access to your coronary arteries — compared to one large incision in traditional CABG surgery. The smaller incisions only expose the areas of the arteries that need grafts instead of the whole heart in a traditional CABG surgery.

Advantages of MIDCAB vs traditional CABG surgery include:

  • Lower risk of infection
  • Smaller incisions mean smaller scars

Disadvantages of MIDCAB vs traditional CABG surgery include:

  • MIDCAB surgery is not appropriate for patients who need bypass grafts on several vessels
  • Due to the smaller incisions, your surgeon can only fix vessels on one side of the heart
Off-pump coronary artery bypass (OPCAB)
OPCAB is a type of minimally invasive coronary artery bypass surgery that requires a smaller incision and does not require the use of a heart-lung bypass machine. During an off-pump coronary artery bypass procedure, your Mercy Health cardiovascular surgeon will take an artery or vein from another area of the body and use that vessel to bypass the blocked vessel to restore normal blood flow.

Patients who have OPCAB typically have less pain and shorter recovery time than patients who have traditional CABG surgeries.

Mercy Health cardiothoracic surgeons have vast experience performing these complicated procedures with excellent results.

Who is a candidate for minimally invasive coronary bypass surgery?

Minimally invasive coronary bypass surgery is not an option for all patients. The ideal candidates are those who:

  • Have one to three vessels that need to be bypassed
  • Is too high risk (older age or suffers from COPD) to undergo traditional CABG surgery

What can you expect during minimally invasive coronary bypass surgery?

Minimally invasive coronary bypass surgery can be performed in a variety of different ways:

  • Robot-assisted heart surgery 
    Your surgeon will use a robot to bypass the blocked vessel. Your surgeon will move the robotic arms at a remote console and views the heart through a 3D monitor.

  • Thoracoscopy surgery
    Your surgeon will insert a thoracoscope with a video camera into an incision in the chest and repair your heart with the instruments that are threaded to the heart through the thoracoscope.

  • Small incision in the chest 

Your doctor will make a small incision between the ribs in your chest to access the blocked vessel(s).

What are advantages of minimally invasive coronary bypass surgery?

There are many advantages of beating heart surgery including:

  • Shorter time in the hospital recovering after surgery
  • Quicker return to normal activity
  • Less risk of infection
  • Less blood loss 
  • Smaller incision 
  • Less scaring
  • Less risk for depression
  • Better survival rate 
  • Fewer complications in the kidney or liver

What are risks of minimally invasive coronary bypass surgery?

Although there are fewer complications associated with minimally invasive coronary bypass surgery than traditional coronary artery bypass surgery, the procedure is still risky. Complications could include:

  • Infection 
  • Bleeding
  • Stroke
  • Wound infection 
  • Arrhythmias
  • Blood clots 
  • Kidney failure
  • Complications from anesthesia
  • Sudden death

Recovery from minimally invasive coronary bypass surgery

Recovery after minimally invasive coronary bypass is less intense than after a traditional CABG. You will spend approximately five days in the hospital recovering from the procedure. Once you are discharged, you will not be able to drive home and should take it easy until you have a doctor’s clearance. You will have a follow-up appointment within a week of your surgery.

Recovery may take a few weeks, as you gradually regain strength. You may be referred to a Mercy Health cardiac rehabilitation program to help you safely get back to your normal activities.

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