MICS CABG is performed through one 5–7 cm incision in the 4th intercostal space (ICS). In some cases the thoractomy may be necessary in the 5th ICS instead. A soft tissue refractor is used to allow for greater visibility and access. MICS CABG may be completed in an "anaortic" or no-touch off-pump technique, which has demonstrated reduced postoperative stroke and mortality compared to tradational CABG.
Two access incisions are also made at the 6th intercostal space and xphoid process to allow for instruments to position and stabilize the heart.
Procedures being performed: