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MICS CABG The right procedure for the right patient

Supporting your choice of surgical therapies for your patients with coronary artery disease (CAD).


For your cardiac surgery patients who ask about faster recovery times, consider recommending a minimally invasive coronary artery bypass graft (MICS CABG) approach. MICS CABG is a beating heart procedure in which the anastomoses are performed under direct vision through an anterolateral mini-thoracotomy. The internal mammary artery (IMA) harvest can also be performed under direct vision, thoracoscopically or robotically. To achieve complete revascularization, a pump-assisted beating heart approach or hybrid coronary revascularization may be performed. Like OPCAB, MICS CABG requires special training and instrumentation to help you achieve enhanced visualization.

Clinical Benefits

Patients who undergo MICS CABG have similar outcomes to the conventional beating heart procedure, but with the added benefit of eliminating the median sternotomy and associated morbidities.1,2 Additional benefits include:

  • Reduced length of hospital stays and recovery times even further than traditional on-pump or off-pump CABG3
  • Enduring results (LIMA-LAD)4
  • Fewer post-op physical restrictions4
  • Improved cosmetic outcomes versus a sternotomy5

Patient Selection Criteria6

MICS CABG is effective for many cardiac patients, but not all. Consider the following criteria when deciding if your patients are eligible for the procedure.

  • Left main coronary artery disease (CAD) with normal right coronary artery (RCA)
  • Triple-vessel disease with medium to large posterior descending artery (PDA)
  • Complex proximal left-sided lesions with or without large branch involvement
  • Previous unsuccessful stenting

OUR Technologies ENABLE Direct Visualization

More than 20 years ago, when we introduced the Octopus™ tissue stabilizers for OPCAB, it changed the way cardiac surgeons could perform beating heart surgeries. For the first time, epicardial tissue could be stabilized using vacuum-assisted technology, making direct visualization possible and completing anastomoses easier on a beating heart. Today, tissue stabilizers are seen as standard for beating heart therapies.

We continue to offer the innovative technologies that help you perform MICS CABG procedures. These include the Medtronic Octopus Nuvo™ tissue stabilizer, Starfish™ NS heart positioner, and ThoraTrak™ MICS retractor system. These devices are shown below as positioned in the body during a MICS CABG procedure.

Placement of Devices for MICS CABG

The Medtronic Octopus Nuvo Tissue Stabilizer

New Ways of Working Together

Minimally invasive cardiac surgery (MICS) procedures like MICS CABG are becoming more mainstream today. As the patient population changes, so do the demands on you, the cardiac surgeon. That’s why Medtronic is committed to supporting MICS CABG. Together — with your skilled knowledge and our enabling technologies —  we can deliver the right therapies for each individual patient with coronary artery disease (CAD).

Learn new beating heart skills and gain hands-on experience with technologies that may be new to you. We offer a full range of training programs. Contact us to learn more.


Puskas J, Cheng D, Knight J, et al. Off-pump versus conventional coronary artery bypass grafting: a meta-analysis and consensus statement From the 2004 ISMICS Consensus Conference. Innovations. 2005; 1: 3-27.


Puskas J, Thourani V, Kilgo P, et al. Off-pump coronary artery bypass disproportionately benefits high-risk patients. Ann Thorac Surg. 2009;88:1142-7.


McGinn JT, Usman S, Lapierre H, Pothula VR, Mesana TG, Ruel M. Minimally invasive coronary artery bypass grafting: dual center experience in 450 consecutive patients. Circulation. 2009; 120:S78-S84.


Poston RS, Tran R, Collins M, et al. Comparison of economic and patient outcomes with minimally invasive versus traditional off-pump coronary artery bypass grafting techniques. Ann Surg. 2008:248:638-646.


Lemma M, Antanasiou T, Contino M. Minimally invasive cardiac surgery-coronary artery bypass graft. Multimedia Manual of Cardio-Thoracic Surgery. Published online 29 June 2013.


Hoff S, McGinn J, Rabindra P, Ramchandani M, Ruel M. MICS CABG Technique Overview. Medtronic. January 2017.


Not all patients are candidates for beating heart procedures. Some patients would require cardiopulmonary support during surgery. 

See the device manual for detailed information regarding the instructions for use, the implant procedure, indications, contraindications, warnings, precautions, and potential adverse events.

For further information, contact your local Medtronic representative and/or consult the Medtronic website at For applicable products, consult instructions for use on Manuals can be viewed using a current version of any major internet browser. For best results, use Adobe Acrobat® Reader with the browser.