Minimally invasive coronary artery bypass grafting

  • Michael Owen Kayatta
  • Michael Emanuel Halkos
  • Pradeep NarayanEmail author
Review Article


Minimally invasive cardiac surgery (MICS)-CABG is a technique that at its core has patient comfort, early return to routine activities, meeting patient expectations for less invasive options, and maintaining the highest possible standards of care and outcomes. The technique requires not only surgical dexterity but also integration of significant technological advancements in patient care. At a time when percutaneous interventions are often prescribed on the pretext of increased patient comfort and demand, minimally invasive myocardial revascularization becomes even more relevant. Minimally invasive myocardial revascularization is ever evolving and encompasses both small-incision open techniques as well as endoscopic-assisted procedures. The success of the procedure depends not only on the learning curve and familiarity with the technology but also on appropriate patient selection. Mere feasibility of the technique is not sufficient, and the results have to be comparable with the long-established techniques of conventional coronary artery bypass grafting both in terms of early morbidity and mortality as well as long-term outcomes. In this review, we discuss patient selection and technical aspects of minimally invasive coronary artery bypass grafting. We also provide an evidence-based comparison to early and long-term outcomes with conventional coronary artery bypass grafting. Finally, we review the uptake and outcomes of minimally invasive revascularization in the Indian subcontinent.


Myocardial revascularization Mini-thoracotomy Coronary artery bypass grafting 



We acknowledge the input of the surgeons participating in the questionnaire survey.

Compliance with ethical standards

There was no funding for this manuscript. Dr. Michael Halkos is a consultant for Medtronic but no funds were received by any of the authors for this review and as such, there are no conflicts of interest. The review details a technique, and no patient-specific details are mentioned and as a result, formal ethical approval was not required.


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Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2018

Authors and Affiliations

  1. 1.Division of Cardiothoracic SurgeryEmory University School of MedicineAtlantaUSA
  2. 2.Department of Cardiac SurgeryNH Rabindranath Tagore International Institute of Cardiac SciencesKolkataIndia

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