Minimally Invasive Coronary Artery Bypass Grafting (MICS CABG)

Introduction

Minimally Invasive Coronary Artery Bypass Grafting (MICS CABG) is an advanced surgical technique used to treat coronary artery disease (CAD). Unlike traditional CABG, which requires a full sternotomy (opening the chest), MICS CABG is performed through a small incision, reducing trauma and allowing for faster recovery.

How It Works

The procedure is typically performed using a left mini-thoracotomy (small incision on the left side of the chest) without the need for cutting through the sternum. The surgeon uses specialized instruments to bypass blocked coronary arteries using the patient's own veins or arteries, ensuring improved blood flow to the heart muscle.

Advantages of MICS CABG

• Less Invasive: No need for full sternotomy, leading to a smaller scar.
• Faster Recovery: Shorter hospital stay (often 3-5 days) compared to traditional CABG.
• Reduced Pain and Complications: Reduced risk of infection and less postoperative pain.
• Earlier Return to Normal Activities: Many patients resume daily activities within a few weeks.

Patient Eligibility

MICS CABG is suitable for patients with single or multiple-vessel coronary artery disease, but the suitability depends on factors such as: - The location and severity of blockages. - Overall heart function. - Presence of other conditions like diabetes or lung disease.

Risks and Limitations

While MICS CABG has many benefits, it is not suitable for all patients. Risks include: - Longer operative time compared to conventional CABG. - Technical challenges requiring experienced surgeons. - Not ideal for patients with very complex multi-vessel disease.

Conclusion

MICS CABG is a promising alternative to conventional CABG, providing effective revascularization with a less invasive approach. If you or a loved one are considering CABG, discussing MICS CABG with a specialized cardiac surgeon may help determine the best approach.

Source recommendations

1. American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for Coronary Artery Bypass Grafting

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001038
2. https://pubmed.ncbi.nlm.nih.gov/34882435/
3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001168
4. https://pubmed.ncbi.nlm.nih.gov/10500052/
5. https://www.acc.org/Latest-in-Cardiology/Articles/2022/10/31/13/02/Key-Takeaways-From-the-2021-Coronary-Revascularization-Guidelines

2. European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) Guidelines on Myocardial Revascularization

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-EACTS-Guidelines-in-Myocardial-Revascularisation-Guidelines-for
2. https://academic.oup.com/eurheartj/article/40/2/87/5079120
3. https://pubmed.ncbi.nlm.nih.gov/25173339/
4. https://academic.oup.com/eurheartj/article/35/37/2541/581070
5. https://www.eacts.org/clinical-practice-guideline/2022-joint-esc-eacts-review-of-the-2018-guideline-recommendations-on-the-revascularization-of-left-main-coronary-artery-disease-in-patients-at-low-surgical-risk-and-anatomy-suitable-for-pci-or-cabg/