Which statement about MIDCAB is correct?

Which statement about MIDCAB is correct?

• A. Performed with sternotomy and CPB
• B. Small left chest incision w/ removal of 4th rib; No sternotomy, CPB, or cardioplegia
• C. Robotic heart surgery uses large incisions
• D. Requires CPB

Answer: (B)

MIDCAB stands for Minimally Invasive Direct Coronary Artery Bypass. It is performed through a small left chest incision, often via the 4th intercostal space and sometimes with removal of part of the left 4th rib to access the target artery, most commonly the LAD. Crucially, it avoids a full sternotomy and does not use cardiopulmonary bypass; the graft is placed on a beating heart with stabilization, so there is no cardioplegia. This explains why the statement describing a small left chest incision with removal of the 4th rib and no sternotomy, no CPB, and no cardioplegia is the correct characterization of MIDCAB. The other options describe approaches that do not match MIDCAB: sternotomy with CPB corresponds to conventional CABG, robotic procedures use different port configurations and are not defined by a large incision, and requiring CPB would not be MIDCAB.

MIDCAB stands for Minimally Invasive Direct Coronary Artery Bypass. It is performed through a small left chest incision, often via the 4th intercostal space and sometimes with removal of part of the left 4th rib to access the target artery, most commonly the LAD. Crucially, it avoids a full sternotomy and does not use cardiopulmonary bypass; the graft is placed on a beating heart with stabilization, so there is no cardioplegia. This explains why the statement describing a small left chest incision with removal of the 4th rib and no sternotomy, no CPB, and no cardioplegia is the correct characterization of MIDCAB. The other options describe approaches that do not match MIDCAB: sternotomy with CPB corresponds to conventional CABG, robotic procedures use different port configurations and are not defined by a large incision, and requiring CPB would not be MIDCAB.