Advantages:

1.                  Reduction of operative trauma.

2.                  Prevention of complications associated with opening of the sternum.

3.                  All known advantages of off-pump coronary artery bypass surgery.

4.                  Cosmetic advantage.

What is MIDCAB surgery?

In MIDCAB surgery, the surgical incision is not a mid-sternotomy but is made at the side of the chest (thoracotomy).

This surgical procedure is designed for patients who require revascularization of the left anterior descending artery.

Instead of a mid-sternotomy incision, it is possible to limit the surgical incision to a small anterior thoracotomy (see picture).  The advantages of this operation, in addition to non-connection to the cardio-pulmonary bypass machine, are reduction of surgical trauma and prevention of morbidity related to a mid-sternotomy.  The surgical scar is hidden below the breast, therefore the cosmetic result is superb.

This procedure is also performed on a beating heart, and it should be pointed out that updated international researches show several advantages to this surgical approach.

Video clip:

MIDCAB coronary artery bypass surgery - 17 sec.

Papers in the field of MIDCAB surgery - PDF version

Midterm follow-up after minimally invasive direct coronary artery bypass grafting versus percutaneous coronary intervention techniques.  Fraund S et al, Ann Thorac Surg 2005;79;1225-31.

Dept. of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center