Minimally invasive heart surgery

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Anterior heart arteries	Coronary artery stent	Heart, front view	Heart bypass surgery - series
Posterior heart arteries

This procedure offers the benefits of conventional open heart surgery but with less traumatic injury. The recovery may be closer to that experienced by angioplasty patients. Unfortunately, the procedure is limited to only a few patients who need only 1-2 bypasses.

OPCAB: During this procedure, the surgeon must cut open the chest and split the breastbone, just like MIDCAB. The difference between the two procedures is that a heart-lung machine is not used. During the procedure, the surgeon makes a cut to open the patient's chest and expose the heart. An artery or vein will be taken from one of the patient's legs, and will be used to make the bypass. Like the MIDCAB procedure, a device is used to restrict movement of parts of the heart so that the surgeon can operate on it while it is still beating. The surgeon can repair four to five vessels on the beating heart during the same procedure.

The use of OPCAB has grown significantly because of its advantages over other procedures. Compared with patients undergoing conventional heart bypass surgery, those undergoing OPCAB require fewer blood transfusions, may have a decreased risk of stroke, have a shorter stay in the hospital after surgery, and may be able to return to normal activities more rapidly.

MIDCAB and OPCAB surgeries both take approximately 3-4 hours.

RACAB is the latest advance in heart surgery. Surgeons use a robot to perform the bypass. The breastbone does not need to be split open at all. Surgeons do not have direct contact with the patient. They perform the operation while watching a videoscreen. As the technology becomes more advanced, the surgeon may perform coronary bypass from a distant site (that is, from another room or another geographical location).

MIDCAB: Due to the limited size of the MIDCAB incision, only certain patients are eligible for the procedure:

1. Patients who have a blockage in one or two coronary arteries located on the front side of the heart, but are considered too high-risk for conventional bypass surgery or balloon angioplasty.