Minimally Invasive Bypass in Obese Patients: Beyond Cosmesis

All articles of this category (opens in new window) Letter to: Minimally Invasive Total Arterial Bypass Grafting via Left Mini-thoracotomy in Obese Patients Thorac Cardiovasc Surg eFirst DOI: 10.1055/a-2668-4842 10.1055/a-2668-4842 We would like to congratulate the authors for their important work on minimally invasive cardiac surgery - coronary artery bypass graft (MICS-CABG) in obese patients.[ 1 ] Based on our own experience with minimally invasive direct coronary artery bypass, we would like to emphasize that the value of this technique extends beyond cosmetic considerations or patient preference. In our extremely obese patients (body mass index >35 kg/m 2 ), the use of a minimally invasive approach provided a particular advantage: Protection against median sternotomy dehiscence, a complication that is relatively frequent and severe in obese individuals. Avoiding full sternotomy in this high-risk subgroup may, therefore, represent not only a technical refinement but also an important preventive strategy against a potentially life-threatening complication. We commend the authors for highlighting the safety and feasibility of this approach and believe that further studies focusing on this specific benefit in obese and extremely obese patients would be of great clinical interest. Publication History Received: 11 September 2025 Accepted: 20 September 2025 Article published online: 03 October 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany