[Less invasive coronary artery bypass grafting]

Myocardial revascularization had its beginnings in the early 1900s with extracardiac operations, such as sympathetic denervation and thyroid ablation. Since than it evolved to saphenous vein- and mammary artery-coronary artery bypass grafting (CABG) on the beating heart in the 1960s and after 1975 with the use of cardiopulmonary bypass (CPB) and cardioplegic arrest. Although excellent short-term and long-term results have been obtained with conventional CABG on cardiopulmonary bypass, there is still significant mortality and morbidity associated with the procedure, especially in the higher risk patients. To reduce surgical trauma off-pump coronary artery bypass grafting (OPCABG) and minimally invasive direct vision coronary artery bypass grafting (MIDCABG) are performed. Totally endoscopic operations are still in experimental stage. In the article optional less invasive surgical techniques are described.