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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