For the appropriate candidates, the Maryland Heart Center offers a minimally invasive surgical approach to treating blockages in the coronary arteries, known as minimally invasive direct coronary artery bypass, or MIDCAB.
What is MIDCAB?
In contrast to open-heart bypass surgery, where the chest is cut open at the sternum to gain access to the heart, the surgeon creates a tiny, two-and-a-half inch opening between two ribs in the left side of the chest. The doctor then removes part of another artery from the chest through this keyhole-size opening and sews it to the heart to bypass the blocked artery.
With this minimally invasive surgery, the heart remains beating throughout the procedure, which is safer and poses fewer side effects than having the patient on a heart-lung machine to maintain circulation.
What are other advantages this approach offers to patients?
This approach offers many advantages to patients, including:
Who are good candidates for this procedure?
The minimally invasive procedure can be used on patients who have blockages that are accessible to bypass through a small incision in the left chest. This depends on the pattern of blockages present in the coronary arteries that are seen in the angiogram that is performed prior to being referred for surgery. If the blockages are present only on the vessels on the left side of the heart, then most likely the patient is a candidate.
If the right sided vessels are also involved, in general, this makes the procedure
not possible. However, a separate procedure, called the hybrid
procedure, may be possible. This procedure involves stenting these right
sided blockages at the same time as the surgical bypass.
How long is the typical hospital stay compared to open heart surgery?
In our experience, the average length of stay is reduced by two days for the minimally invasive procedure (from an average of five days down to three days).
Are many cardiac surgeons performing this procedure?
Because this procedure requires specialized skills, it is only performed by a few cardiac surgeons around the country, including surgeons at the Maryland Heart Center.
Why come to the Maryland Heart Center?
There are several unique advantages the Maryland Heart Center offers patients who are candidates for this approach. First, a wide range of options are available to maintain the minimally invasive approach such as the standard MIDCAB, the hybrid procedure and even multi-vessel bypass through the keyhole incision.
Second, as a tertiary referral center, our program has experience dealing with high-risk patients who derive an even greater benefit from this less invasive approach.
Third, extensive use of graft imaging techniques during and after the surgery virtually eliminates the chance that a surgical defect will result from this novel approach that compromises the function of the bypass graft.
Finally, we are developing an extensive research experience in the effects of blood clotting during these procedures that may be utilized to improve the long-term results of the graft without increasing the risks of bleeding during the surgery.
Whom do I contact for more information?
For more information or to schedule an appointment, call at 410-328-9169.
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