Minimally invasive cardiac surgery: surgical techniques and nursing considerations

Coronary artery bypass grafting is a well-established procedure. Less invasive procedures have been developed to provide bypass grafting without median sternotomy, cardiopulmonary bypass, or cross clamping. Using a small anterior thoracic incision, and occasionally with the aid of the thoracoscope, the minimally invasive direct coronary artery bypass graft (MIDCAB) procedure was developed. The MIDCAB procedure results in a decreased length of hospital stay, fewer postoperative complications, and a more rapid recovery for the patient. The MIDCAB, however, has other ramifications, including changes in staffing requirements, bed allocations, and staff training. Advantages and limitations are discussed.