Minimally invasive direct coronary artery bypass (MIDCAB)

  • No.1 in the UK for private cardiac surgery
  • Appointments in as little as 24 hours
  • 99% of our cardiac patients would recommend us to friends and family
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MIDCAB AT HCA UK

Why choose us?
We’re rated No.1 in the UK for private cardiac care. That means we carry out more private coronary artery bypass grafting (CABG) procedures than any other provider, often using a minimally invasive approach. And, with a 99.6% success rate in coronary artery bypass surgery, you can be confident you’re in safe hands.

You’ll receive exceptional care from a team that includes over 235 cardiovascular consultants, working in specialist multidisciplinary teams including doctors, clinical nurses, surgeons and physiotherapists. They’re supported by an incredible network of state-of-the-art facilities, including five cardiac centres and six cardiac theatres. 

No wonder 99% of our patients would recommend us to friends and family.
If you need a coronary artery bypass graft (CABG), your consultant might recommend a minimally invasive option called MIDCAB (minimally invasive direct coronary artery bypass). Your consultant might also suggest MIDCAB as an alternative to open-heart surgery, as it uses a small 3-5cm incision, which can result in a faster recovery. 

If you have coronary disease affecting multiple arteries, your consultant might recommend a CABG to improve blood flow to your heart. This is usually done through open-heart surgery, where the surgeon makes an incision down the centre of your chest to reach the affected arteries. They’ll also make a smaller incision on your leg to take a healthy blood vessel to use for the bypass.
When we talk about a “hybrid approach”, we’re referring to minimally invasive coronary revascularisation, which combines minimally invasive coronary artery bypass surgery (MIDCAB) with percutaneous coronary intervention (PCI).

Typically, your consultant will insert one or more stents to widen (revascularise) other narrowed coronary arteries. Either at the same time, or soon after, your cardiac surgeon will perform a MIDCAB procedure to bypass the left anterior descending artery (LAD) through a small incision on the left side of your chest.

This approach aims for a long-lasting bypass of the LAD, performed while the heart is beating. The stenting of other arteries can be done during the same hospital stay or as a staged procedure with short intervals in between. Your consultant will advise what’s best for your particular case.
MIDCAB reduces invasiveness while still providing the benefits of open heart surgery. You’re likely to spend a shorter time in intensive care and in hospital overall before being able to return home. 

Rest assured, you’ll be closely monitored by your specialist rehabilitation team and consultant after any procedure and be given detailed advice before you’re discharged home.
An expert in our heart health team will assess whether this approach is suitable for you at a face-to-face or virtual consultation at The Harley Street Clinic. It all depends on your individual condition and general health, and they’ll be best placed to advise you on your next best steps.
Nurse with patient

200+

cardiology consultants to choose from

36,000+

patients treated every year

99.6%

success rate for heart bypass surgery

Next-day appointments

See a specialist and get on the path to an expert diagnosis within 24 hours

State-of-the-art diagnostics

With results in as little as 48 hours

Wide-reaching expertise across the UK

Visit any one of 15 dedicated diagnostic centres in London, Manchester and Birmingham

The MIDCAB process

What to expect
Our expert teams are here to ensure that you’re as comfortable, informed and reassured as possible at every stage, from your initial enquiries and consultation until you’re able to be discharged home. 

If you have any questions, we’re happy to help. Please don’t hesitate to get in touch.

01

Initial consultation

Whether you’ve self-referred or have a referral from a GP, the first step will be an initial consultation with one of our specialists.  

You’ll be seen by a specialist consultant and a cardiac surgery clinical nurse specialist. They’ll ask you about your symptoms and medical history and carry out a physical examination.

02

Investigations and diagnosis

We’ll conduct a range of tests which are designed to establish as much detail as possible about your case and determine the best treatment for you. The tests your team recommends may include blood tests, electrocardiogram (ECG), echocardiogram, cardiac CT scan with calcium score, X-ray, exercise stress test or a cardiac stress test

Once we have the results back, we’ll create a detailed treatment plan including advice on what you should do ahead of your admission into one of our hospitals. You’ll also be advised on what preparations you should make ahead of time for your eventual discharge.

This will include information about the medications you may need to take, what type of food and drink you can have after the procedure, and what sort of support and care you’re likely to need at home while you recover.

03

Treatment

A conventional heart bypass operation typically lasts three to four hours, depending on the complexity of your case.

Your specialist cardiac surgeon will carefully select healthy blood vessels from another part of your body, such as your arm or your leg. They’ll discuss this with you beforehand to make sure you’re completely comfortable with everything that’s happening. To get to your heart, the surgeon will make an incision along your breastbone. During the procedure, your heart will be gently stopped using medication, and a heart-lung machine will temporarily take over the function of circulating blood and oxygen throughout your body.

The surgeon will then attach the harvested blood vessels around the blocked artery, creating a new and reliable pathway for blood flow to bypass the obstruction.

Once these new pathways are secured, your surgeon will restart your heart and carefully rejoin and secure your breastbone. Finally, they’ll close the incision so that it can heal.
 

04

Aftercare

Immediately after surgery, you'll be transferred to a cardiac intensive care unit, where you’ll be closely monitored by our dedicated team before moving to a high-dependency unit or a cardiac ward. You should be out of bed the next day, but you'll need to stay in hospital for around a week.

After you’ve been discharged, you'll need help at home, so should arrange for someone to stay with you for a couple of weeks. You'll also need to arrange for someone to help you get home from the hospital as you won’t be able to drive for one month.

Within the first few days of being home, you’ll be encouraged to do very gentle activities, such as walking short distances or lifting light objects, building up gradually to more strenuous activities in the following weeks. 

You’re likely to have made a full recovery after about three months, although your own recovery time will depend on your fitness, age and how severe your initial arterial disease was. Your consultant will follow up with you about six weeks after the operation and your whole heart health team will be at hand to offer advice and support throughout your recovery.

Where can I have my MIBCAB surgery?

Across our extensive network of hospitals and treatment centres, we have more than 235 expert cardiovascular consultants who can help you, from initial consultation through to surgery and recovery.

We currently offer MIDCAB at:
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The Harley Street Clinic

35 Weymouth Street  W1G 8BJ London
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London Bridge Hospital

27 Tooley Street SE1 2PR London

Accessing private health care

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Self-pay

You don’t need health insurance to be seen quickly. If you’re looking for a diagnosis or treatment and don’t want to wait, all our private healthcare services – from private GP appointments through to surgery and aftercare – can be paid for as and when you need them. 
 
And to give you peace of mind from the start, we’ll offer you a clear and transparent quote outlining exactly what’s included in your self-pay package.

Book an appointment

FAQs

Although MIDCAB surgery is a minimally invasive procedure, it’s still a major operation and, as with any surgery, it comes with potential risks and complications. Our expert consultants and cardiologists will be here to offer you guidance and discuss the potential risks with you ahead of your procedure.

Factors that may affect your risk of complications include your age and whether you have any other serious health conditions, such as diabetes, Chronic Obstructive Pulmonary Disease (COPD) or kidney disease. Your consultant and cardiologist will explain these risks to you. 

At HCA UK, we’re proud that our success rate for heart bypass operations is 99.6%.
As you'll be having a general anaesthetic, you'll be asked to stop eating and drinking for six hours beforehand.

Once you've been discharged, you'll need help at home, so you should arrange for someone to stay with you for a couple of weeks following the procedure. You'll also need to arrange for someone to help you get home from the hospital, as you won’t be able to drive for a month.
If you have coronary heart disease, having heart bypass surgery can help improve your quality of life. You may be experiencing shortness of breath, fatigue and palpitations because of coronary heart disease, symptoms that a heart bypass operation can help to alleviate.

Our patients’ stories

I usually tried to avoid doctors and hospitals as much as I could, so I was pretty worried. However, Professor Doshi’s bedside manner and the way he explains everything is very reassuring. Any questions I had, he’d answer them. He was straight to the point and very caring.

Steve
HCA UK heart patient