Advances in surgical technology and a long history of success with coronary artery bypass graft surgery have brought about an important new technique for this vital treatment for coronary artery disease. With smaller instruments and refinements in the use of surgical scopes, the “minimally invasive” technology that has revolutionized many other fields of surgery has now been introduced into cardiovascular medicine.

Also referred to as limited access coronary artery surgery, endoscopic coronary artery bypass graft surgery now takes place through small incisions in the chest, avoiding the large opening through the sternum that is required for open-heart surgery. Much of the procedure is the same as for the traditional surgery, with a vein taken from another location, usually in the chest area, to serve as the bypass graft. In some situations, the heart-lung bypass machine is used so the heart can be stilled during the operation. However, in some cases, such as when the number of diseased vessels is small, the procedure may be performed without the heart-lung bypass machine, while the patient’s heart continues to pump blood to the body. The surgeon views the operative site on a video monitor throughout the procedure.

Advantages of performing the procedure without the heart-lung bypass machine include:

• Smaller incisions, smaller scars

• Reduced operative and post-operative risks

• Less blood loss during surgery

• Faster recovery time and return to usual activities.