Myocardial Revascularization Surgery: conventional versus minimally invasive technique

Abstract

Coronary artery bypass grafting (CABG) is considered one of the main procedures for the treatment of coronary artery disease, particularly in patients with extensive lesions or refractory to medical and percutaneous therapy. Traditionally, the conventional technique, performed through median sternotomy with the support of cardiopulmonary bypass, has been the therapeutic standard, providing consistent results in terms of survival and symptom control. However, technological advancements and the pursuit of less invasive approaches have favored the development of minimally invasive techniques, such as MIDCAB (Minimally Invasive Direct Coronary Artery Bypass) and TECAB (Total Endoscopic Coronary Artery Bypass). These methods offer benefits related to reduced postoperative pain, shorter hospital stay, and faster functional recovery, although they still present limitations, such as a long learning curve, longer operative times in certain contexts, and restrictions in the treatment of multivessel disease. The aim of this article is to compare the conventional technique with minimally invasive approaches, highlighting their advantages, limitations, impact on clinical outcomes, and future perspectives for cardiovascular surgical practice.