MIDCAB — small access bypass surgery
After its first introduction in 1967 by Kolesov, MIDCAB regained new interest in the early 1990s. At that time Benetti, Calafiore, Subramanian and Boonstra [1-3, 13] reported on LIMA grafting to the LAD through a similar minithoracotomy using specialized equipment for intrathoracic exposure and local immobilization of the target area. Along with the availability of suitable equipment a broad interest for MIDCAB grafting developed, as MIDCAB combines the two major procedural advantages of beating off-pump surgery and minimal access. Beside the ‘original’ MIDCAB procedure (beating heart off-pump, anterior minithoracotomy, LIMA-LAD bypass) several modifications have been attempted including parasternal incisions and inferior ministernotomies [7, 9, 12]. Sometimes mobilization or partial resection of one or two ribs became necessary.
KeywordsMinimally Invasive Direct Coronary Artery Bypass Invasive Direct Coronary Artery Bypass Endothoracic Fascia Intercostal Hernia Distal Pedicle
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