Get answers to your heart-related questions from UM Heart Center experts.
Minimally invasive direct coronary artery bypass; MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart.
Minimally invasive coronary (heart) artery bypass can be done without stopping the heart and putting a patient on a heart-lung machine.
A heart surgeon will make a 3- to 5-inch-long incision (cut) in the left part of your chest between your ribs. This allows the surgeon to reach your heart. Muscles in the area will be pushed apart. A small part of the front of the rib, called the costal cartilage, will be removed. Then the surgeon will find and prepare an artery in your chest to attach to your coronary artery that is blocked.
Once the above steps are done, the surgeon will connect the prepared chest artery to the coronary artery that is blocked.
You will not need to be on a heart-lung machine for this surgery, but a device will be attached to your heart to slow it down.
Your doctor may recommend a minimally invasive coronary artery bypass if you have a blockage in one or two coronary arteries, usually in the front of the heart. When one or more of the coronary arteries becomes partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease or coronary artery disease. It can cause chest pain (angina).
Coronary artery disease (CAD) is when the small blood vessels that supply blood and oxygen to the heart become narrow or blocked.
Your doctor may have first tried to treat you with medicines. You may have also tried cardiac rehabilitation or other treatments, such as angioplasty with stenting.
Coronary artery disease varies a lot from person to person, so the way it is diagnosed and treated varies. Heart bypass surgery is just one treatment. It is not right for everyone.
Ferraris VA, Mentzer RM Jr. Acquired heart disease: coronary insufficiency. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 61.
Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116(23):2762-2772.
Møller CH, Perko MJ, Lund JT, et al. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial. Circulation. 2010 Feb 2;121(4):498-504. Epub 2010 Jan 18.
Thiele H, Neumann-Schniedewind P, Jacobs S, et al. Randomized comparison of minimally invasive direct coronary artery bypass surgery versus sirolimus-eluting stenting in isolated proximal left anterior descending coronary artery stenosis. J Am Coll Cardiol. 2009 Jun 23;53(25):2324-31.
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