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Robotic-assisted MIDCAB procedure through a minithoracotomy: Step-by-step instructions.

Alexander Aerden1, Michiel Marynissen1,2, Wouter Oosterlinck2

  • 1Department of Cardiac Surgery, Imelda Bonheiden, Belgium Department of Cardiovascular Sciences, research unit cardiac surgery, University hospitals Leuven, Belgium

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|November 4, 2022
PubMed
Summary

Robotic-assisted minimally invasive direct coronary artery bypass grafting (MIDCAB) offers a safe alternative for complex coronary artery disease. This technique provides fast recovery and good long-term outcomes for select patients.

Keywords:
Beating-heart surgeryCABGCoronary artery bypassCoronary artery bypass graftingCoronary artery diseaseCoronary surgeryHybrid cardiac surgeryMIDCAB surgeryMinimally invasive cardiac surgeryMinimally invasive coronary artery bypass graftingMinimally invasive direct coronary artery bypass surgeryMyocardial revascularizationOff-pump MIDCABRobotic-assisted minimally invasive direct coronary artery bypass grafting

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Techniques
  • Robotic Surgery

Background:

  • Minimally invasive cardiac surgery (MICS) is advancing, with complex techniques reducing morbidity.
  • Robotic-assisted minimally invasive direct coronary artery bypass grafting (MIDCAB) is a safe and effective option across risk groups.

Observation:

  • A case report details a young male with familial hypercholesterolemia and chronic total occlusion of the left anterior descending artery (LAD).
  • The patient underwent successful robotic-assisted MIDCAB via minithoracotomy in January 2021.

Findings:

  • The procedure was uncomplicated, resulting in a rapid recovery and 3-day hospital discharge.
  • Robotic-assisted MIDCAB is a technically demanding yet safe minimally invasive alternative for severe coronary lesions unsuitable for percutaneous coronary intervention.

Implications:

  • This technique, particularly in hybrid coronary revascularization, minimizes surgical risk and optimizes long-term outcomes.
  • Further experience may lead to guidelines and integration into heart-team decision-making for personalized patient care.
  • This case report serves as a training resource for this complex surgical procedure.