Last updated: 11/24/2009

Minimally invasive heart surgery is performed on the diseased heart to reroute blood around clogged arteries and improve the blood and oxygen supply to the heart. This approach provides patients some benefit in that cardiopulmonary bypass (use of a...

heart-lung machine) may be avoided, and smaller incisions can be used instead of the standard sternotomy (incision through the sternum, or breast bone) approach. Faster recovery time, decreased procedure costs, and reduced morbidity and mortality are the goals of this technique.

Minimally invasive technique is not new to the field of cardiac surgery. It was performed as early as the 1950s, although the technology associated with stabilizing the cardiac structure during the procedure has become more sophisticated. Also, the anesthesiologist and perfusionist (person monitoring blood flow) have developed better techniques to preserve cardiac function during the procedure to help the surgeon achieve the desired outcome. During the 1990s these new techniques were named: off-pump CABG (OPCAB) and minimally invasive direct coronary artery bypass (MIDCAB). The MIDCAB procedure includes procedures done both with and without cardiopulmonary bypass, the later being referred to as off-pump MIDCAB. Unless otherwise specified, MIDCAB refers to both types of procedures.

Minimally invasive valve surgery has been an outgrowth of the success with minimally invasive coronary artery bypass grafting. Incisions other then the traditional sternotomy allow access to the heart. Minimally invasive valve surgery still requires cardiopulmonary bypass, since this is a true open-heart procedure, (i.e. this is not surgery that is done while the heart is beating). New tools in managing cardioplegic cardiac arrest allow for the smaller incision unobstructed by the required instrumentation. Cannulation of the femoral vessels instead of the larger vessels of the heart also improves visualization.