minimally invasive heart surgery…

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heart, posterior heart arteries, anterior heart arteries, coronary artery stent, heart bypass surgery, minimally invasive direct coronary artery bypass, midcab, off-pump coronary artery bypass, opcab, beating heart surgery, racab, robot assisted coronary artery bypass, keyhole heart surgery, minimally invasive heart surgery, several approaches, bypassing critically blocked arteries, less difficult, risky than conventional open-heart surgery, coronary artery bypass grafting, cabg, approaches restore healthy blood flow, heart, having to stop the heart, put the patient on a heart-lung machine, surgery, currently, three procedures that use this approach, minimally invasive direct coronary bypass, midcab, off-pump coronary artery bypass, opcab, robotic assisted coronary artery bypass, racab, each of these procedures has the potential benefit of avoiding complications associated, the heart-lung machine increased risk of stroke, lung complications, kidney complications, mental clarity, memory, benefits, faster recovery, reduced hospital costs, midcab is suitable, patients, blockages, arteries on the front, the heart, left anterior descending, lad, artery, its diagonal branches, procedure allows the surgeon to perform bypass surgery, splitting the breastbone, unlike conventional open-heart bypass surgery, a large incision, midcab employs a tiny, 6-10 cm "keyhole" incision on the patient's left chest to gain access, heart, surgeons, use midcab incisions, the heart-lung machine, opcab, surgeon makes a vertical incision, in the chest the same, used in conventional bypass surgery, splits the breastbone, difference, the heart-lung machine is not used, a stabilizing device, restrict movement of small segments, the heart so that the surgeon, operate on it it is still beating, procedure enables the surgeon to perform multiple-vessel, 4-5, bypass surgery on a beating heart, racab, latest advance in coronary surgery, surgeons use a robotic device to enable coronary bypass, separating the breastbone at, surgeons, not have direct contact, the patient, perform the operation watching a videoscreen, the technology becomes more advanced, surgeon, perform coronary bypass, a distant site, from another room, another geographical location, midcab, procedure offers the benefits of conventional cabg but produces less traumatic injury, recovery closer to that experienced by angioplasty patients, unfortunately, procedure is limited to a small subset of patients requiring bypass surgery who need only 1-2 bypasses, operation, surgeon makes an incision approximately 6-10 cm long on the front, the chest toward the left side, pectoral muscles, divided, a small portion, the front, the rib, costal cartilage, removed, surgeon clamps off the internal mammary artery, ima, lies just beneath this cartilage, frees its lower end, an opening is made, in the pericardium, sheath covering the heart, a mechanical stabilizer is attached, heart to reduce its movement, surgeon connects the mammary artery below the blockage, left anterior descending, lad, artery, one of its branches, once the clamp on the mammary artery is released, blood, flow, ima, the lad artery, bypassing the blockage, providing oxygen-rich blood, heart muscle, opcab, use of this procedure has grown significantly, its advantages over conventional cabg, midcab procedure, compared, patients undergoing conventional cabg, undergoing opcab, require fewer blood transfusions, decreased risk of stroke, shorter post-operative hospital stay, able to return to normal activities more rapidly, surgeon opens the patient's chest, a 12- to 14-inch incision over the breastbone, divides it to expose the heart, simultaneously, mammary artery, greater saphenous vein, the patient's legs, blood vessels, "harvested", in the bypass procedure, midcab procedure, a mechanical heart stabilizer is employed to restrict the heart movement, bypasses, constructed, blocked arteries on the heart, midcab, opcab surgeries both take approximately 3-4 hours, midcab, limited size, the midcab incision, certain patients, eligible, the procedure, patients, a blockage in one, two coronary arteries located on the front side, the heart, considered too high-risk, conventional bypass surgery, balloon angioplasty, healthy but have a blockage in one, two coronary arteries located on the front side, the heart, every patient, coronary artery disease, candidate, opcab, younger patients, small coronary arteries, need several bypasses, whose heart, not tolerate manipulated, preferable, use the traditional cabg technique, currently, following patients, coronary artery disease, potential candidates, opcab, patients, poor heart function, very low ejection fraction, patients, severe lung disease, chronic obstructive pulmonary disease, copd, emphysema, patients, acute, chronic kidney disease, patients at high risk, stroke, patients, a calcified aorta, performing surgery on a beating heart, midcab, opcab procedures, technically more difficult than working on a heart, stopped, the help, the heart-lung machine, stress on the heart, lead to more heart muscle damage, lower blood pressure, irregular heart beat, potentially, brain injury, blood flow, brain is reduced, too long, surgery, less than 10%, necessary to convert to conventional cabg methods on an emergency basis, midcab, opcab patients typically spend one day, in the surgical intensive care unit, move to a regular surgery unit, where they receive cardiac rehabilitation, average hospital stay is 3 days, midcab patients, 5-7 days, opcab patients, a hospital stay of 6-10 days is typical, conventional cabg patients, patients, had midcab have lower chest wound infection rates than patients, undergone cabg, opcab, a smaller incision means less exposure, handling of tissue, reduces the chance of infection, midcab patients recover more quickly than those who undergo cabg, opcab, 2 weeks, most midcab patients, return to normal activity level, compared, 2-3 months, patients, had conventional surgery, opcab patients have a recovery that in most respects is similar to, cabg patients, able to return to full activity, work, 2-3 months after operation.