Minimally invasive cardiac surgery

Minimally Invasive Cardiac Surgery, also known as MICS CABG (Minimally Invasive Cardiac Surgery/Coronary Artery Bypass Grafting) or The McGinn Technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an anterolateral mini-thoracotomy. Minimally Invasive Cardiac Surgery, also known as MICS CABG (Minimally Invasive Cardiac Surgery/Coronary Artery Bypass Grafting) or The McGinn Technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an anterolateral mini-thoracotomy. Advantages of Minimally Invasive Heart Surgery are less blood loss, reduced post-operative discomfort, faster healing times and lowered risk of infections, as well as eliminating the possibility for deep sternal wound infection or sternal non-union. This procedure makes heart surgery possible for patients who were previously considered too high risk for traditional surgery due to age or medical history. Patients referred for this procedure may have Coronary Artery Disease (CAD); aortic, mitral or tricuspid valve diseases; or previous unsuccessful stenting. MICS CABG is performed through one 5–7 cm incision in the 4th intercostal space (ICS). In some cases the thoractomy may be necessary in the 5th ICS instead. A soft tissue refractor is used to allow for greater visibility and access. MICS CABG may be completed in an 'anaortic' or no-touch off-pump technique, which has demonstrated reduced postoperative stroke and mortality compared to tradational CABG. Two access incisions are also made at the 6th intercostal space and xphoid process to allow for instruments to position and stabilize the heart.