Medical Health Encyclopedia

Minimally invasive heart surgery

During the procedure, the surgeon opens the patient's chest with a 12- to 14-inch incision over the breastbone and divides it to expose the heart. Simultaneously, the mammary artery and the greater saphenous vein from one of the patient's legs or other blood vessels are "harvested" for use in the bypass procedure. Like the MIDCAB procedure, a mechanical heart stabilizer is employed to restrict the heart movement. With this procedure, bypasses can be constructed for any blocked arteries on the heart.

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

Indications:

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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.

2. Patients who are otherwise healthy but have a blockage in one or two coronary arteries located on the front side of the heart.

In general, every patient with coronary artery disease is a candidate for OPCAB. However, for younger patients, for those who have small coronary arteries and need several bypasses, or those whose heart will not tolerate being manipulated during the procedure, it may be preferable to use the traditional CABG technique. Currently, the following patients with coronary artery disease are potential candidates for OPCAB:

1. Patients with poor heart function (very low ejection fraction).

2. Patients with severe lung disease (chronic obstructive pulmonary disease, COPD, and emphysema).

3. Patients with acute or chronic kidney disease.

4. Patients at high risk for stroke.

5. Patients with a calcified aorta.

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