Minimally invasive direct coronary artery bypass (MIDCAB) is the latest technique in cardiac surgery and has now become a routine procedure in Turkey, highlighting its advantages, risks, and identifying the right patients for this procedure.
Overview of coronary artery bypass surgery
The heart pumps blood to all parts of the body to supply them with oxygen and essential nutrients, but who feeds the heart itself?
The coronary arteries are responsible for this and ensure the heart’s constant supply of oxygen.
Coronary artery disease, which causes narrowing of one or more of the coronary arteries, impedes blood flow to the heart and can cause angina or myocardial infarction.
To treat this condition, the doctor may administer vasodilator drugs that help increase blood flow to the heart, such as nitrates and calcium channel blockers, or dilate the narrowed vessels using the percutaneous coronary intervention (PCI) technique or bypass the blockage with a coronary artery bypass graft using a secondary and dispensable vessel from the patient’s body (to avoid immune rejection) by connecting it before and after the blockage.
Traditionally, this operation was performed using the beating heart technique, where the doctor had to spread the sternum and operate on a beating heart with the help of special techniques—a challenging and risky procedure for both the doctor and the patient.
Today in Turkey, it is possible to place these bypasses using minimally invasive direct coronary artery bypass techniques.
Through small incisions in the chest wall without the need for a long incision, the surgery is performed with the latest robotic systems and technologies, enabling the surgeon to work precisely within a narrow space.
This procedure falls under the category of laparoscopic heart surgery and represents a major advancement in cardiac care.
What is minimally invasive coronary artery bypass surgery?
Minimally invasive direct coronary artery bypass surgery (also known as beating heart surgery) is a less invasive alternative to traditional coronary artery bypass graft surgery (CABG).
Minimally invasive direct coronary artery bypass can improve blood flow to the heart without the potential complications, use of a cardiopulmonary bypass machine, and long recovery time associated with traditional CABG and open-heart surgery.
Types of minimally invasive direct coronary artery bypass
Beating heart surgery is performed while your heart is still beating, so you don’t need the help of a heart-lung bypass machine. There are two types of minimally invasive direct coronary artery bypass:
Minimally invasive direct coronary artery bypass (MIDCAB)
If your doctor recommends MIDCAB, you won’t need the help of a heart-lung bypass machine to keep your heart beating during the procedure.
You’ll also need smaller incisions in the chest to access the coronary arteries compared to one large incision in traditional CABG surgery.
Smaller incisions reveal only the areas of the arteries that need grafting, rather than the entire heart in open CABG surgery.
The advantages of MIDCAB versus traditional CABG surgery include the following:
- Reduced risk of infection.
- Smaller incisions mean fewer scars.
MIDCAB surgery is not suitable for patients who require multi-vessel bypasses, because the surgeon can repair the vessels on only one side of the heart.
Off-pump coronary artery bypass (OPCAB)
OPCAB is a type of minimally invasive coronary artery bypass surgery that requires a smaller incision and does not require the use of a cardiopulmonary bypass device.
During an off-pump coronary artery bypass procedure, your cardiovascular surgeon will take an artery or vein from another area of the body and use this vessel to bypass the blocked vessel to restore normal blood flow.
Patients who have OPCAB usually have less pain and shorter recovery times than patients who have undergone traditional CABG surgeries. For more information, please read about the use of robotics in cardiac surgery and its results in Turkey.
You can learn more about aortic bypass surgery in Turkey on our website.
Who is a candidate for minimally invasive coronary bypass surgery?
Minimally invasive coronary bypass surgery is not an option for all patients.
Ideal candidates for minimally invasive coronary artery bypass surgery are:
- Who has one to three narrowed arteries
- Very high risk of undergoing traditional CABG surgery (elderly or with chronic obstructive pulmonary disease)
Studies have shown that minimally invasive coronary bypass surgery can be performed in elderly patients.
What to expect during minimally invasive direct coronary artery bypass in Turkey?
Minimally invasive direct coronary artery bypass can be performed in several different ways:
- Robot-assisted heart surgery: To bypass a blocked vessel, the surgeon uses a robot to remotely control the robotic arms and view the heart through a 3D screen.
- Thoracoscopic surgery: The surgeon will insert a thoracoscope with a video camera into an incision in the chest wall and repair the heart with tiny instruments that are attached to the heart through the thoracoscope.
- Small incision in the chest: Your doctor will make a small incision between the ribs in your chest to access the blocked blood vessels.
What are the advantages of minimally invasive direct coronary artery bypass?
There are several advantages to beating heart surgery:
- Shortest hospitalization time for recovery after surgery
- Faster return to normal activity
- Lower risk of infections
- Less blood loss
- Smaller incision
- Lower risk of depression after surgery
- Better survival rate
- Fewer kidney or liver complications
What are the risks of minimally invasive direct coronary artery bypass?
Although there are fewer complications associated with minimally invasive coronary bypass surgery compared to traditional coronary artery bypass surgery, the procedure is still risky and can include complications:
- Infection
- Bleeding
- Stroke
- Wound infection
- Irregular heartbeat
- Blood clots
- renal failure
- Complications of anesthesia
- Sudden death
Considering minimally invasive direct coronary artery bypass?
At Bimaristan Medical Center in Turkey, we connect you with top specialists to ensure safe surgery and ongoing support after your procedure.
Contact us in Bimaristan anytime — your health is our priority.
Recovering from MIDCAB
Recovery after minimally invasive direct coronary artery bypass is faster and easier than recovery after traditional CABG.
You will spend about five days in the hospital recovering from the procedure. Once you are discharged from the hospital, you will not be able to drive home and should not exert yourself until you get clearance from the doctor. You will have a follow-up appointment within a week of the surgery.
Recovery may take a few weeks. As you gradually regain your strength, you may be referred to a cardiac rehabilitation program to help you safely return to your normal activities, as Bimaristan Medical Center in Turkey assists you in all stages of treatment and follow-up and guides you to the best doctors and treatment centers in Turkey.
Minimally invasive direct coronary artery bypass is one of the most advanced surgical methods currently in use.
It also offers advantages that the traditional method does not, as minimally invasive direct coronary artery bypass does not carry as much risk to the patient as other methods.
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