Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011;3(4):249-53.

The MIDCAB approach in its various dimensions

J Cremer  1 , J Schoettler, A Thiem, C Grothusen, G Hoffmann
Affiliations

The MIDCAB approach in its various dimensions

J Cremer et al. HSR Proc Intensive Care Cardiovasc Anesth. 2011.

Abstract

Introduction: Minimally invasive direct coronary artery bypass grafting (MIDCAB) offers arterial revascularization of the left anterior descending coronary artery especially in lesions unsuitable for percutaneous coronary interventions. By avoidance of sternotomy and cardiopulmonary bypass its invasivity is less than that of conventional bypass surgery.

Methods: A literature search of all published minimal invasive direct coronary artery bypass grafting studies was performed for the period from January 1995 through November 2011. Additionally, the authors reviewed their experience in more than one thousand patients treated by minimal invasive direct coronary artery bypass grafting within the last 14 years at their institution.

Results: Early mortally ranged from 1.2 to 1.3%. Midterm mortality ranged up to 3.2%. At 6-month follow up 3.6% grafts were occluded and 7.2% had a significant stenosis which resulted in target vessel revascularization in 3.3% of cases. The conversion rate to sternotomy or cardiopulmonary bypass ranged between 1.2 and 6.2%.

Conclusions: In the past MIDCAB was predominantly used in patients with isolated lesions of the left anterior descending coronary artery. In combination with percutaneous interventions it provides an attractive option for full revascularization in multi vessel disease especially in older patients with significant comorbidities. Overall minimal invasive direct coronary artery bypass grafting is associated with few perioperative complications and with high graft patency rates in the mid-term and long-term course.

Keywords: MIDCAB; arterial revascularization; coronary artery disease; hybrid procedure; minimally invasive cardiac surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest None declared.

References

    1. Kolessov VI. Mammary artery-coronary artery anastomosis as method of treatment for angina pectoris. J Thorac Cardiovasc Sug. 1967;54:535–544. - PubMed
    1. Calafiore AM, Di Giammarco G, Teodori G. et al. Left anterior descending coronary artery grafting via left anterior small thoracotomy without cardiopulmonary bypass. Ann Thorac Surg. 1996;61:1658–1665. - PubMed
    1. Subramanian VA, Sani G, Benetti FJ. et al. Minimally invasive coronary artery bypass surgery: a multi-center report of preliminary clinical experience. Circulation. 1995;92:1645–1645.
    1. Lichtenberg A, Klima U, Paeschke H. Impact of multivessel coronary artery disease on outcome after isolated minimally invasive bypass grafting of the left anterior descending artery. Ann Thorac Surg. 2004;78:487–491. - PubMed
    1. Holzhey DM, Jacobs S, Mochalski M. et al. Minimally invasive hybrid coronary artery revascularization. Ann Thorac Surg. 2008;86:1856–1860. - PubMed

LinkOut - more resources