What are the surgical approaches used for coronary artery bypass grafting (CABG)?

Updated: Dec 04, 2019
  • Author: Rohit Shahani, MD, MS, MCh; Chief Editor: Karlheinz Peter, MD, PhD  more...
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The usual incision used for CABG is a midline sternotomy (see the image below), although an anterior thoracotomy for bypass of the LAD or lateral thoracotomy for marginal vessels may be used when an off-pump procedure is being performed. Cardiopulmonary bypass, cardioplegic arrest, and placement of the graft follows.

Illustration of a median sternotomy. Illustration of a median sternotomy.

Alternative approaches to CABG include the following:

  • Off-pump CABG

  • Minimally invasive direct CABG (MIDCAB)

  • Totally endoscopic CABG

  • Hybrid technique (bypass plus stenting)

  • Robotic-assisted CABG

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