Minimally invasive coronary surgery: fad or future?

Minimally invasive coronary surgery is a radical modification of conventional coronary artery bypass surgery and is performed through a small thoracotomy, the surgeon anastomosing the left internal mammary artery to the left anterior descending artery without the use of either cardiopulmonary bypass or cardioplegic arrest.1 2 Since its description in 1994,1 few new techniques in cardiac surgery have aroused such interest or had such a rapid diffusion. Initial enthusiasm, however, has been followed by a wave of scepticism. As the indications for minimally invasive coronary surgery become clearer it is time for a calmer apraisal. Initial enthusiasm for the technique arose because it avoided the need for cardiopulmonary bypass3 and provided an opportunity to reduce the use of health- care resources. Inevitably there were early failures, and some investigators began to highlight …