Minimally Invasive Coronary Artery Bypass Grafting on the Beating Heart

The American Experience
  • Valavanur A. Subramanian
Part of the Contemporary Cardiology book series (CONCARD)


Interest in minimally invasive coronary artery bypass grafting (MICABG) on the beating heart is growing. The premise for adopting these less invasive approaches is that patient morbidity can be reduced without compromising the safety and efficacy of conventional CABG. Despite the encouraging early clinical results reported by Benetti (1), Buffolo (2), Pfister (3), Subramanian (4), Calafiore (5), and their associates, CABG without cardiopulmonary bypass (CPB) via midline sternotomy or minithoracotomy has met with concerns of technical limitations and efficacy of anastomosis (6–8). Recently, the introduction of surgical instrumentation to facilitate internal mammary artery (IMA) harvest, mechanical local immobilization and stabilization of coronary artery target sites has enabled standardization of the surgical technique for left internal mammary artery to left anterior descending (LIMA-LAD) anastomosis by a minimally invasive direct coronary artery bypass (MIDCAB) approach, with predictable good results.


Right Coronary Artery Internal Mammary Artery Beating Heart Coronary Bypass Grafting Midline Sternotomy 
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© Springer Science+Business Media New York 1999

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  • Valavanur A. Subramanian

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