MINIMALLY INVASIVE CORONARY-ARTERY BYPASS-GRAFTING

Minimally invasive cardiac surgery has generated a tremendous amount o f enthusiasm in the cardiology and cardiac surgical communities. Coron ary revascularization without cardiopulmonary bypass through a small a nterior thoracotomy or mediastinotomy has been introduced as an altern ative to the conventional approach. An endovascular or port-access tec hnique for cardiopulmonary bypass and cardioplegic arrest has been dev eloped for use in cardiac surgery. This peripherally based system achi eves aortic occlusion, cardioplegia delivery, and left ventricular dec ompression; thus, coronary revascularization and various cardiac proce dures can be effectively performed in a less invasive fashion than con ventional median sternotomy. Continued technical advances in minimally invasive cardiac surgery will facilitate these procedures, increase p atient safety, and contribute to acceptable long-term results.