Evolving strategies in minimally invasive coronary artery surgery

It is estimated that approximately 25% of cardiac surgery will be performed through minimal access by the year 2000. While original efforts focused on performing minimally invasive cardiac surgery totally thoracoscopic, and with cardiopulmonary bypass, more recent realistic approaches rely on small targeted incisions and video assisted techniques on the beating heart. Current instrumentations which provide segmental stabilization of the heart eliminate the need for cardioplegic arrest and cardiopulmonary bypass. While early results are encouraging, intermediate and long term clinical outcome and graft patency remain to be determined.