Off-Pump Bypass Surgery including MIDCAB

Off pump bypass surgery is a surgical process for the treatment of coronary artery disease that eliminates the need for patients to be on a heart bypass, or heart-lung, machine. This can greatly reduce complications and recovery time from the more traditional technique of performing bypass surgery.

What is MIDCAB?

When only one or two coronary arteries need to be bypassed, a MIDCAB (Minimally Invasive Direct Coronary Artery Bypass) approach may sometimes be used.

The MIDCAB procedure is performed in a similar fashion as off pump bypass surgery. The difference is that a small 2- to 3-inch incision is made on the left side of the patient's chest. This small incision, or mini-thoracotomy, allows the surgeon to bypass the anterior vessels of the heart using the left internal mammary artery as the conduit. Patients requiring more than one or two bypasses, or who need other vessels besides the anterior vessels of the heart bypassed, may not be candidates for this procedure.

Occasionally the right internal mammary or the gastoepiploic artery can be used to bypass the right coronary artery.