Limited-access surgical coronary artery revascularization

The continued evolution of surgical revascularization has resulted in much less invasive alternatives for patients undergoing coronary artery bypass grafting. In particular, techniques and technologies have been developed to allow for the grafting of coronary arteries through limited access incisions without the circulatory support of cardiopulmonary bypass. The conduits are generally arterial rather than the venous alternatives used originally, and the harvesting of these conduits is performed through limited access incisions described in another article in this review. The result of these efforts is sternal-sparing solutions for the off-pump coronary artery bypass grafting of all the various coronary locations on the heart. This is accomplished through a spectrum of small incisions that can directly expose any specific area of interest for focal bypass grafting. The surgical insult is greatly reduced and the patient's recovery is significantly enhanced. These efforts continue to bring us closer to the ultimate goal of 24-hour hospital stays for coronary artery bypass grafting patients.