Minimally invasive coronary bypass: experience at the Erasme Hospital in 1997-1998

Since the launching of cardiopulmonary bypass in 1952 the landscape of cardiac surgery has been marked by a major milestone every ten years. Though most of the cardiopathies can be surgically treated with satisfactory results in up to 90% of the cases, we must try to improve the existing results. That means--Can we do better, cheaper and less invasive? Several new surgical approaches aiming at so doing are discussed in the present report: Minimally invasive direct coronary arterial bypass (MIDCAB) which is performed through a small anterior thoracotomy; Beating heart revascularization through sternotomy; Heart Port approach; Trans Myocardial Laser Revascularization (TMLR). Those new technologies respectively offer specific advantages to the existing therapies thus represent promising alternatives in selected subcategories of patients.