Last updated: 11/24/2009

MIDCAB can result in a higher rate of restenosis (recurrence of narrowing of the arteries) then traditional coronary artery bypass grafting, but these numbers continue to decrease as experience with the procedure improves. Some patients may have to...

have the procedure converted to a standard sternotomy with cardiopulmonary bypass, if the anastomosis can not be completed from the MIDCAB approach. Rib fracture is the most common adverse event. Pericarditis also is a possible complication. Supraventricular arrhythmias and ST segment elevation also may develop.

In the event of systemic blood pressure abnormalities, arrhythmia, poor surgical anastomosis, or poor exposure of the coronary blood vessels, OPCAB patients may require conversion to cardiopulmonary bypass for completion of the anastomosis. Post-operatively some patients may need additional surgery to control bleeding or to address poor sternal healing. This is related to the increased use of both internal mammary arteries for these procedures. Cerebral complications and atrial fibrillation also may be experienced. These post-operative complications are comparable to those seen in patients who have undergone traditional coronary artery bypass grafting.