Low invasive coronary surgery: overview of coronary heart disease modern surgical treatment techniques

Over the last twenty years, cardiovascular diseases come first among the causes of death in the world. In particular, the ischemic heart disease has reached the greatest growth during this period, the number of deaths from it now is about 16% of the total mortality. Surgical methods take a leading position in the treatment of coronary artery disease comparing with conservative therapy, both in short and long term perspective. Traditional coronary artery bypass through sternotomy with the use of artificial blood circulation remains a traumatic procedure with a high risk of complications, both intraoperative and in the early and late postoperative periods. Transdermal coronary interventions, being less traumatic, have a significant disadvantage in the form of a high rate of restenosis and repeated revascularization. The attempts to get rid of these disadvantages and to unite the advantages of the above techniques led to the creation of such promising direction as minimally invasive coronary surgery (MICH), which is a good alternative to sternotomy, having a similar safety and efficiency profile in comparison with the conventional coronary artery bypass with or without the use of artificial blood circulation. At present, the MICH technique can be considered both as a separate method of surgical treatment, and as the first stage of hybrid myocardial revascularization. In this overview the definition of the MIKH is presented, the combined detailed classification of all techniques of minimally invasive coronary revascularization, their advantages and disadvantages is given.