Minimally invasive direct coronary artery bypass surgery

Surgical treatment for coronary heart disease

Minimally invasive direct coronary artery bypass surgery
ICD-9-CM	36.33
[edit on Wikidata]

Minimally invasive direct coronary artery bypass (MIDCAB) is a surgical treatment for coronary heart disease that is a less invasive method of coronary artery bypass surgery (CABG).^[1] MIDCAB gains surgical access to the heart with a smaller incision than other types of CABG. MIDCAB is sometimes referred to as "keyhole" heart surgery because the operation is analogous to operating through a keyhole.

MIDCAB is a form of off-pump coronary artery bypass surgery (OPCAB), performed "off-pump" – without the use of cardiopulmonary bypass (the heart-lung machine). MIDCAB differs from OPCAB in the type of incision used for the surgery; with traditional CABG and OPCAB a median sternotomy (dividing the breastbone) provides access to the heart; with MIDCAB, the surgeon enters the chest cavity through a mini-thoracotomy (a 2-to-3 inch incision between the ribs).

MIDCAB surgery is no longer reserved for only anteriorly placed single- or double-vessel diseases, because such lesions are usually managed with angioplasty. The surgery has recently begun to be used in multi-vessel coronary disease.

MIDCAB in hybrid revascularization

People with multi-vessel coronary disease, who desire a minimally invasive approach to surgery may be eligible for hybrid bypass. A hybrid approach combines coronary bypass (using the MIDCAB approach) and coronary stenting.

References

^ Nakagawa, Hirofumi; Nabuchi, Akihiro; Terada, Hirohito; Hiranuma, Susumu; Miyazaki, Takuya; Okuyama, Hiroshi; Endo, Masahiro (2015). "Minimally Invasive Direct Coronary Artery Bypass Surgery with Right Gastroepiploic Artery for Redo Patients". Annals of Thoracic and Cardiovascular Surgery. 21 (4): 378–381. doi:10.5761/atcs.oa.14-00286. PMC 4904875. PMID 25912220.

Tests and procedures involving the heart

Cardiac surgery
Interventional cardiology
Cardiology diagnostic tests and procedures
Cardiac imaging

Surgery

Heart valves and septa	Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Transcatheter Mitral valve replacement Transcatheter pulmonary valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock–Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of the great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock–Taussig shunt SVC to the right PA Glenn procedure
Cardiac vessels	CHD Angioplasty Bypass/Coronary artery bypass MIDCAB Off-pump CAB TECAB Coronary stent Bare-metal stent Drug-eluting stent Obstacle removal Endarterectomy Atherectomy Bentall procedure Valve-sparing aortic root replacement LeCompte maneuver
Other	Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure (Cox maze and minimaze) Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion S-ICD implantation ICD implantation Cardiac resynchronization therapy Left atrial appendage occlusion Cardiotomy Heart transplantation