Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative procedure to open-heart coronary artery bypass graft (CABG). Unlike the conventional CABG, MIDCAB requires only a small incision and the breastbone does not have to be split.

 
Through a small two to three inch incision between the ribs, the surgeon can gain access to the blocked artery and a bypass can be performed to restore blood flow to the heart. This procedure is performed while the heart is beating, avoiding the use of a heart-lung machine, which reduces complications associated with traditional CABG surgery.

Candidates for this procedure can have only one blockage and it must be located on the front of the heart, in the left anterior descending coronary artery. Because there is less trauma to the chest, there is less pain involved and recovery is faster. The typical hospital stay is only a few days. This surgery is also referred to as “keyhole” surgery.