Coronary artery bypass graft (CABG) surgery is a procedure performed to treat narrowing or blockage in the coronary arteries that supply blood to the heart. This procedure is generally recommended for patients with severe coronary artery disease that may cause symptoms such as chest pain, shortness of breath, and an increased risk of heart attack. During bypass surgery, surgeons create a new pathway using blood vessels from another part of the body to restore blood flow to the heart.
Traditionally, conventional bypass surgery has been associated with sternotomy, a procedure in which the breastbone is opened to access the heart. However, advances in cardiac surgery technology now allow bypass surgery to be performed using Minimally Invasive Cardiac Surgery (MICS), a minimally invasive surgical technique that does not require opening the breastbone. This method has become one of the latest innovations in cardiac surgery because it is performed through small incisions.
Mandaya Royal Hospital Puri provides MICS coronary bypass surgery performed by dr. Wirya A. Graha, Sp.BTKV, Subsp. JD (K), a thoracic, cardiovascular, and vascular surgeon with a subspecialty in adult cardiac surgery who specializes in minimally invasive cardiac procedures. With a more modern and minimally invasive approach, this service offers an alternative for patients who require bypass surgery without undergoing conventional sternotomy.
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Understanding MICS Coronary Bypass Surgery: Small Incisions Without Sternotomy
Minimally Invasive Cardiac Surgery (MICS) coronary bypass surgery is a procedure designed to create a new pathway for blood flow around narrowed or blocked coronary arteries. Unlike conventional bypass surgery that requires opening the breastbone, the MICS approach is performed through a small incision of approximately 5 cm between the ribs or beneath the left chest area.
During this procedure, surgeons use specialized instruments to carefully attach bypass grafts while the heart continues beating. To ensure precision and safety, stabilizing devices are also used to keep the heart area steady throughout the operation.
Because the procedure is performed through smaller incisions, MICS coronary bypass surgery tends to cause less trauma to the body and may help patients recover more quickly. However, this procedure requires a cardiac surgeon with specific expertise and experience in minimally invasive heart surgery.
Differences Between MICS and Conventional Coronary Bypass Surgery
Both MICS coronary bypass surgery and conventional bypass surgery aim to restore blood flow to the heart by treating narrowed or blocked coronary arteries. The main difference lies in how surgeons access the heart during the procedure.
In conventional bypass surgery, surgeons need to open the breastbone to reach the heart. In contrast, the MICS approach is performed through small incisions between the ribs without sternotomy. For this reason, MICS is considered a less invasive surgical technique.
Some advantages of MICS coronary bypass surgery compared to conventional bypass surgery include:
- Faster recovery, allowing most patients to resume daily activities within approximately 2–4 weeks
- Less postoperative pain
- Smaller surgical scars
- Reduced physical and psychological trauma from surgery
- Shorter hospital stays
- Better early recovery of lung function
- Lower risks of infection and bleeding
However, not all patients are suitable candidates for MICS coronary bypass surgery. In some complex or severe heart conditions, conventional bypass surgery may still be the safest and most effective option. Therefore, surgeons will conduct a thorough evaluation to determine the most appropriate surgical method for each patient.
Read also: Heart Surgery Without Sternotomy: MICS Coronary Bypass by dr. Wirya A. Graha
Who Is Eligible for MICS Coronary Bypass Surgery?
Minimally invasive coronary bypass surgery may be an option for patients who:
- Have coronary artery disease caused by narrowed coronary arteries
- Require bypass surgery without undergoing major sternotomy
- Prefer a potentially faster recovery period
- Have undergone evaluation and are considered suitable candidates by a cardiac surgeon
When Should You See a Doctor?
Coronary bypass surgery is generally performed in patients with severe coronary artery disease involving significant narrowing or blockage of the heart’s blood vessels. Therefore, it is important to consult a doctor immediately if you experience symptoms related to coronary artery disease, especially if the symptoms occur frequently, worsen over time, or interfere with daily activities.
Symptoms of coronary artery disease that should not be ignored include:
- Chest pain (angina) that may feel like pressure, tightness, heaviness, or squeezing in the chest
- Chest pain triggered by physical activity or emotional stress
- Pain spreading to the arms, shoulders, neck, back, jaw, or upper abdomen
- Shortness of breath
- Unusual fatigue, even without strenuous activity
- Cold sweats
- Nausea or discomfort in the upper abdomen
- Sudden dizziness or lightheadedness
In some individuals, especially women, older adults, and people with diabetes, heart disease or heart attack symptoms may appear atypical. Symptoms may only include nausea, mild neck or back pain, or unusual fatigue. Some patients may even experience a heart attack without noticeable warning signs.
Seek immediate medical attention if you experience sudden chest pain, severe shortness of breath, or symptoms suspected to be related to a heart attack so treatment can be provided as quickly as possible.
Consultation with dr. Wirya A. Graha at RS Mandaya Royal Puri
dr. Wirya A. Graha is a thoracic, cardiac, and vascular surgeon with a subspecialty in adult cardiac surgery. He completed his Thoracic and Cardiovascular Surgery specialist training at the Faculty of Medicine, Universitas Indonesia, and has extensive experience in performing various cardiac and vascular surgical procedures.
dr. Wirya has broad experience in cardiac surgery, performing more than 600 surgeries annually. More than 300 of these cases involve minimally invasive heart surgery techniques, including over 200 coronary bypass surgeries and more than 100 heart valve procedures using similar minimally invasive approaches.
His expertise in minimally invasive cardiac surgery allows procedures to be performed without fully opening the breastbone. This approach may provide several benefits to patients, including less postoperative pain, lower complication risks, and faster recovery compared to conventional surgery.
In addition to MICS coronary bypass surgery, dr. Wirya also performs various other procedures, including heart valve surgery, aortic surgery, and other thoracic and cardiovascular procedures. He is also a member of the Ikatan Dokter Indonesia and is committed to providing safe, professional, and patient-oriented cardiac surgical care.
dr. Wirya A. Graha is available at Mandaya Royal Hospital Puri on:
- Tuesday: 4:30 PM – 8:00 PM
- Thursday: 4:30 PM – 8:00 PM
- Saturday: 10:00 AM – 1:00 PM
To make your visit to Mandaya Royal Hospital Puri more convenient, you can use the WhatsApp Chat feature, Book Appointment service, or the Care Dokter application available on Google Play and the App Store to schedule visits, check queue numbers, and access other important information.
The information provided on this page is intended for educational and general informational purposes only and may not represent the full scope of medical services available from each doctor. To ensure appropriate treatment according to your health condition, direct consultation with the relevant doctor is recommended.
If you have questions, suggestions, or require further information, please contact our call center at 0811-1900-2000.
