MIDCAB "BEATING HEART" SURGERY

The new MIDCAB (Minimally Invasive Direct Coronary Artery Bypass) procedure enables surgeons to access and bypass diseased arteries using the internal mammary artery or other suitable vascular grafts. The procedure is performed through a 3- to 4-inch incision between the fourth and fifth ribs, exposing the surface of the beating heart.

Under the surgeon's direct vision, the healthy artery is grafted directly onto the coronary artery while the heart continues beating.

Our cardiothoracic surgery team uses a special MIDCAB system that holds a small area of the beating heart motionless so the surgeon can place sutures with precision. This procedure stabilizes the area with pressure on either side of the artery to be bypassed, and it eliminates the need to stop the heart and route the blood through a heart-lung machine.

In contrast to traditional coronary artery bypass graft (CABG) surgery, which involves a 12- to 15-inch lengthwise incision through the ribcage, MIDCAB surgery takes half the time and requires an average hospital stay of only three days versus four or five days.

Moreover, most patients usually recuperate in 10 to 14 days compared with the six to eight weeks for traditional CABG.

The healing and recovery time is much shorter because the trauma to both soft tissue (skin and muscle) and hard tissue (bone) is greatly reduced.

MIDCAB is currently being used in patients with single-vessel coronary disease who are not candidates for angioplasty or stent procedures and in patients who have failed these cardiologic procedures (about one third of the patients).

MIDCAB has also been used to treat patients who are at too high a risk for traditional CABG, such as patients with poor ventricular function or previous bypass surgery. Recently, it has been extended to patients with multi-vessel coronary artery disease.