[Anesthesia for minimal invasive coronary surgery without employing extracorporeal circulation]

In the course of present reevaluation of aortocoronary bypass grafting a minimal invasive surgical procedure avoiding the use of cardiopulmonary bypass has been revised. It is suitable born for palliative treatment of patients with coronary multi-vessel-disease and compromised left ventricular function, and likewise for curative treatment of patients with single-vessel disease of a left coronary artery branch and unimpaired ventricular function. Avoiding possible complications of cardiopulmonary bypass can minimise morbidity and lethality of aortocoronary bypass grafting procedure and can help to lower costs. Anaesthesia for minimal invasive direct coronary artery bypass grafting needs an anaesthesiological concept differing from anaesthesia for conventional coronary artery bypass surgery. This concept, considering the special aims of minimal invasive technique, is discussed and demonstrated by means of case reports.