title: Minimally invasive direct coronary artery bypass (MIDCAB).
abstract: Recently, coronary artery bypass graft without cardiopulmonary bypass, which is named minimally invasive coronary artery bypass, has received attention from cardiac surgeons. In 1996, Calafiore introduced left anterior small thoracotomy (LAST) for coronary artery revascularization. Today, this procedure is named minimally invasive direct coronary artery bypass graft (MIDCAB) and presented in many clinical reports because of its less invasiveness and economic advantage. MIDCAB is performed on LITA to LAD by LAST as a standard procedure. Now, this technique has been modified in many ways so that bypass surgery can be performed on RGEA to RCA or on circumflex artery by mini-sternotomy. Multiple-branch bypass surgery has been performed in an increasing number of patients. MIDCAB has technical difficulties to ablate the internal artery for providing bypass, with an extremely small wound left, and to reconstruct complete blood flow with this technique alone. However, combination of MIDCAB with intervention could provide reconstruction of favorable blood flow. This paper deals with the indication, surgical procedure, problems and future views of MIDCAB.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, 6-11-1 Ohmori-nishi, Ohta-ku, Tokyo 143-8541, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: N
authors.initials: N
authors.lastname: Koyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013895:Thoracic Arteries / Q000601:surgery; D013908:Thoracotomy / Q000379:methods