Cardiac surgeons are trying innovative approaches to traditional open heart surgery

According to Millennium Research Group (MRG), the global authority on medical technology market intelligence, cardiac surgeons are trying new innovative approaches to traditional open heart surgery as they try to make coronary artery bypass graft (CABG) procedures less invasive where possible.

Developments in CABG techniques have led to the introduction of less invasive variations of CABG surgery. Minimally invasive direct coronary artery bypass, for example, involves making a small incision between the ribs in order to access the heart. Instead of creating the necessary 10 to 12 inch incision to separate the sternum, minimally invasive direct coronary artery bypass keeps the sternum intact and only requires a 3 to 5 inch incision.  

Totally endoscopic coronary artery bypass is another minimally invasive variation of CABG that makes use of Intuitive Surgical's da Vinci robot.  The da Vinci can be used during CABG procedures by inserting robotic instruments through small incisions made in between the patient's ribs. The robotic instruments are able to provide the physician with a 3D internal image, which has been magnified 10 times and mimics the hand movements of the physician at the controls. While the advantages of totally endoscopic coronary artery bypass, including reduced patient recovery time and greater postoperative patient comfort, are similar to those that result from minimally invasive direct coronary artery bypass procedures, the use of a robot allows for the procedure to be performed with greater ease.

"Minimally invasive direct coronary artery bypass procedures are not appropriate for all patients though," says Julie McLaughlin, Analyst at MRG. "They only allow physicians to reach a limited number of coronary arteries, therefore limiting the procedure to patients who require only one or two vessel bypasses. These patients can often be treated with stents, and physicians who perform minimally invasive direct coronary artery bypass procedures have indicated that they are performing fewer procedures than in previous years due to increased treatment of eligible minimally invasive direct coronary artery bypass patients with stents. The procedure is also technically more difficult to learn and perform compared to alternatives.  For this reason it is not anticipated that many physicians will start performing minimally invasive direct coronary artery bypass procedures over the next five years."

MRG's US Markets for Coronary Artery Bypass Graft Devices 2011 report includes analysis on on-pump coronary artery bypass devices, off-pump coronary artery bypass devices, endoscopic vessel harvesting devices, and anastomosis assist devices.