MIDCAB - Minimally Invasive Direct Coronary Artery Bypass Surgery

MIDCAB is different from traditional bypass surgery:

• Your surgeon makes an incision to the left of your breast bone below the level of your breast.
• You will not have to be placed on the heart lung machine.
• The technique is most often used with patients who require only one bypass.
• The stitches are usually internal and will dissolve on their own without being removed.
• It will take you less time to recover.

What Happens During Surgery?

1. The doctors will give you anesthesia to put you to sleep and will insert tubes (IVs) in your neck just as with traditional bypass surgery.
2. A tube will be placed in your mouth which will connect you to a breathing machine.
3. An incision is made to the left of your breast bone below the level of your breast.
4. Special instruments and scopes are used to remove an artery (mammary artery) from the inside of the chest wall so the artery can be used for bypass. Once the mammary artery is taken down from the inside of the chest wall, the artery of your heart which is to be bypassed is clamped so that the bypass can be attached to the coronary (heart) artery.
5. After surgery, the incision will be covered with a bandage and you will be taken from the operating room to the Surgical Heart Unit (SHU).

What Happens After Surgery?

1. You will wake up with tubes (IVs) in your neck. The breathing tube will still be in your mouth. As soon as you are awake enough, the breathing tube will be taken out. This usually occurs about 2-6 hours after surgery.
2. You will be encouraged to cough, breathe deeply and do frequent breathing exercises. This is necessary to prevent fluids from collecting in your lungs after surgery.
3. Later in the evening, you will be offered a light meal.
4. The tubes (IVs) in your neck may remain until the next day.
5. When you are ready, we will assist you to sit in the chair. This usually occurs within eight hours after surgery.
6. After surgery, you may be able to walk short distances in the hall with help.
7. You will be able to go home in 1-3 days or when your health care team feels you are ready.
8. Sexual activity can be resumed 3-4 weeks after your surgery, once you can walk up and down two flights of stairs without difficulty (for some patients, it may be sooner.)

Discharge Instructions

• Take care of your incision. Gently wash it with mild soap and warm water. Do not scrub. Pat dry.
• You may bathe four days after surgery.
• Use your breathing devise (incentive spirometer) 4-5 times a day for the first week at home.
• You should wear your support stockings during the day every day until you see your surgeon.
• You are encouraged to walk around the house and short distances outside. Gradually increase the distances you walk. You may go up and down stairs.
• You may lift no more than 10 pounds until you see your surgeon.
• Do not drive until you see your surgeon, usually in one week.
• You may go back to work in 1-2 weeks, depending on your type of work. If you do manual labor, it may be longer.

Call your surgeon or clinical nurse specialist if you have any of the following:

• A fever of 101^oF
• A weight gain of 3 pounds in one week
• Any redness, swelling, drainage, or odor from your incisions
• Any irregular or fast heart beat that is new
• Any shortness of breath
• Any questions