Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)- Cardiology

Doctors: Cardiologist, Cardiac Surgeon

What is Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) surgery?

MIDCAB is an open-heart bypass surgery in which an artery from the chest will be used to create a new blood supply to the heart muscle. The upper end of the artery is attached to a branch of the aorta so only the lower end is cut and repositioned.

The procedure:

Patient is given anesthesia. The surgery commonly takes around two to four hours. The surgeon will create a tiny, around two-and-a-half inch opening between two ribs in the left side of the chest.  A small operating camera (called a scope) and surgical instruments might be may be placed through 3 small incisions in the side of your chest between the ribs to take down the artery used to bypass the blocked heart vessels. An artery is harvested from the chest and is stitched to the coronary arteries through the keyhole-size opening.

All these steps are done while the heart is still beating, hence the patient do not need to be shifted to a heart-lung bypass machine. This would greatly decrease the risk of post-operative bleeding, stroke, and kidney failure.

What to expect after the procedure?

Patient would have some chest pain and will be given pain medications. Patient would be required to stay in hospital for certain number of days depending on his/her condition. Once the patient leaves the hospital, he/she will be required to visit the doctor’s office for regular follow-up.

References:

• https://www.umms.org/ummc/health-services/heart-vascular/services/coronary-artery-disease/heart-bypass-surgery/midcab
• https://www.lhsc.on.ca/cardiac-care-services/minimally-invasive-direct-coronary-artery-bypass-midcab

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