Full sternotomy approach remains the gold standard for coronary bypass surgery, mainly because surgery is indicated in case of severe and diffuse lesions which need several bypass with complete revascularization. However, when the number of significant coronary artery lesion is limited to one or two vessels, an alternative to full sternotomy is a small left mini-thoracotomy which provides a space large enough to perform one or two bypass anastomoses under direct vision, using the left mammary artery.
This Minimally Invasive technique is well known as MIDCAB procedure (Minimally Invasive Direct Coronary Artery Bypass) and it is recognized as the safer minimally invasive technique in coronary bypass surgery, especially to bypass the LAD.
