We offer patients a minimally invasive procedure to treat blockages in the coronary arteries. Minimally invasive direct coronary artery bypass, or MIDCAB, requires specialized skills and intensive training.

The surgeons at the University of Maryland Heart and Vascular Center are among the few surgeons in the country performing this technically challenging procedure.

What is MIDCAB?

In an open heart bypass procedure, surgeons need to cut the chest open to access to the heart. This creates a large scar and requires a lengthy recovery period. During a MIDCAB procedure, we will:

  • Create a tiny, two-and-a-half inch opening between two ribs in the left side of the chest. 
  • Harvest an artery from the chest. We may do this directly or we may use a surgical robot. 
  • Stitch the artery to the coronary arteries through the keyhole-size opening. We perform this stitching, or suturing, while the heart is still beating, so you do not need to go on a heart-lung bypass machine.

We may combine the MIDCAB procedure with catheter-based intervention on the coronary arteries in a hybrid coronary intervention. This procedure involves stenting these right-sided blockages at the same time as the surgical bypass. Learn more about hybrid coronary intervention.

Advantages of MIDCAB

In addition to a smaller incision and less scarring, advantages of a MIDCAB procedure include:

  • Quicker recovery times
  • Less time in the hospital (in general, your hospital stay following a MIDCAB may be two days shorter than the hospital stay after an open heart procedure)
  • Decreased need for blood transfusion
  • No manipulation of the ascending aorta that may cause neurologic injury

MIDCAB Candidates

You may be a candidate for a MIDCAB procedure if you have blockages that we can access to bypass through an incision in the left chest. We will perform an angiogram to determine the pattern of blockages in your coronary arteries. If the blockages are only on vessels on the left side of your heart, then you may be a candidate for this procedure.

We may also decide to use this approach if we determine that using the heart-lung machine is too risky for your health. This may be the case if you have additional diseases such as:

  • Chronic pulmonary disease
  • Peripheral vascular disease
  • Kidney failure

Learn more about our expertise with coronary revascularization.