Minimally invasive coronary artery bypass surgery

Abstract

Development of various coronary artery bypass surgery techniques up to the most modern procedures is comprehensively analyzed in the article. On-pump and off-pump coronary artery bypass grafting (OPCAB) through median sternotomy are compared. We described the benefits of OPCAB over on-pump CABG in patients with multifocal atherosclerosis, chronic obstructive pulmonary disease, chronic kidney disease and other severe comorbidities. Results of original trials devoted to this problem were discussed. The criteria for selecting certain surgical approach (median sternotomy or left-sided mini-thoracotomy) for CABG are described. The role, advantages and efficiency of hybrid technologies are evaluated. Development of minimally invasive technologies such as MIDCAB and MICS CABG are presented in detail. We analyzed advantages, difficulties and prospects of these technologies. The evidence of the advantages of this technique over conventional CABG is shown. Considering these data, MICS CABG may be considered as one of the main methods of minimally invasive myocardial revascularization in short-term period.