Surgical and anesthetic considerations for patients undergoing minimally invasive coronary artery bypass surgery mini- sternotomy and mini -thoracotomy approaches

ABSTRACT

Minimally invasive surgical techniques for coronary bypass grafting [CABG] have not been advanced until recently. Successful grafting of the internal mammary artery [IMA] to the coronary arteries has been a surgical practice since 1987[1]. To retain the benefits of IMA grafting and to offset the invasiveness of the conventional CABG , Robison et al. have recently described a minimally invasive approach to CABG using a mini-anterior mediasternotomy approach [2]. Arom et a1. have also described a partial sernotomy approach ,Whereas Subramanian et al. have described a minimally invasive access using a mini lateral thoracotomy [3]. All these approaches can be performed under direct vision. MIDCAB [minimally invasive direct vision coronary artery bypass]. This study discuss these individual surgical techniques and examines the anesthetic concerns for patients undergoing minimally invasive CABG with both the ministernotomy and minithoracotomy approaches