Minimally
Invasive Direct Coronary Artery Bypass (MID-CAB)
Why is the doctor performing this surgery?
To bypass, or go around, the obstruction caused by a coronary
(heart) artery filled with a clot or with plaque (atherosclerosis).
If the obstruction is not bypassed, the heart muscle beyond
the obstruction is denied oxygen and nutrients. It differs
from traditional coronary
artery bypass surgery because it is a less invasive procedure,
using smaller incisions to improve stability and to speed
recovery, and does not require the use of a heart-lung machine.
What is the surgery?
Minimally Invasive Direct Coronary Artery Bypass is known
as "MID-CAB." Minimally invasive means that the
surgeon accesses the heart with less trauma, and thru a smaller
incision, than traditional bypass surgery. Most often, the
left anterior descending (LAD) coronary artery will be bypassed,
using the left internal mammary artery (LIMA) as the bypass
graft. The steps are:
- The left internal mammary artery
(the graft artery for the bypass) is reached thru a 4-6 inch
incision on the left side of the chest.
- Medications are given intravenously
to slow the heart down for the surgery.
- A special stabilizing device is used
to keep the involved portion of the heart as still as
possible for the surgeon to work.
- Blood flow thru the left anterior
descending artery stops as this artery is clamped off.
- The lower end of the internal
mammary artery is detached, then reattached to the anterior
descending artery just below its blockage.
- Blood flow then bypasses the blockage as it travels thru
the internal mammary artery, supplying vital oxygen and
nutrients to the heart muscle beyond the blockage.
Where is the surgery performed?
In the Operating Room (OR), under general anesthesia.
How long does this surgery take?
MID-CAB usually takes about 2 hours.
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