FAQ: Ask Dr. McGinn a Question

Have a question for Medical Director of The Heart Institute and renowned cardiothoracic surgeon, Dr. Joseph McGinn? You can search the frequently asked questions below or submit a query of your own. We will respond within 24 hours.

If you are not feeling well and need immediate medical attention, DO NOT send us email. Call your doctor or 911.

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Q:
My husband is 55 years old, overweight, has high cholesterol and has smoked for a good number of years. He also has a touch of emphysema and a family history of heart disease. He’s been having pain in his left arm but no pain in his chest. I am concerned and would like your advice.

A:
Based on the information, your husband is at high risk for coronary artery disease and the pain in his left arm may be related to this. Do not wait, I highly suggest that he see a cardiologist as soon as possible. In the future, if he develops left arm pain, he should go to the emergency room for an immediate evaluation.

Q:
What is the difference between traditional open heart surgery and MICS CABG?

A:
To reach the heart in traditional bypass surgery, a sternotomy incision, approximately 6″ – 8″ in length, is made midline on the chest and through the breastbone. It can be performed as “off-pump” surgery or, if necessary, the heart can be stopped and a heart-lung machine is used to help maintain the circulation of blood and oxygen content of the body.

Upon completing the traditional open heart surgery, the breastbone is wired together and then the sternotomy incision closed. It is a highly invasive process with a long recovery phase. Postsurgery complications are not uncommon.

In comparison, MICS CABG is performed via three small incisions on the chest, approximately 1″- 2″ in length, and without having to break the ribs or the breastbone. With small incisions and no broken bones to heal, postsurgery complications are not typical and patients usually see a full recovery within the month after surgery.

Q:
What does MICS CABG stand for?

A:
MICS CABG — pronounced mix cabbage — is short for minimally invasive cardiac surgery/coronary artery bypass grafting.

Q:
What are the benefits of MICS CABG?

A:
• Less pain (no broken bones)
• Lower risk of wound infection
• Fewer restrictions, including no driving restrictions
• Faster recovery, many patients are discharged from the hospital within two to three days and can return to work within two weeks
• Improved cosmetic outcome

Q:
Who is a candidate for MICS CABG?

A:
MICS CABG can be performed on most patients who need bypass surgery. The following criteria are just a few reasons why it may be right for you:
• Advanced age
• Long-term steroid use
• Severe COPD (Chronic Obstructive Pulmonary Disease)
• Severe deconditioning
• Need for other major operative procedure
• Patients with severe arthritic or orthopedic problems

Q:
Is MICS CABG considered experimental heart surgery?

A:
No. Since developing the technique in 2005, Dr. McGinn has performed hundreds of MICS CABG procedures with an exceptional success rate.

Q:
Why don’t more doctors know about/perform this procedure?

A:
MICS CABG is a relatively new, advanced technique that most physicians have not been trained to perform. Although we do offer ongoing, peer-to-peer training sessions led by Dr. McGinn, only a handful of physicians perform the procedure worldwide.

Q:
What is the history of MICS CABG?

A:
The first MICS CABG was performed on January 21, 2005, at The Heart Institute by a highly trained cardiac team led by Dr. Joseph McGinn. This minimally invasive technique, where proximal grafts were anastomosed to the mammary artery, was performed for two years with a favorable outcome. After taking this procedure to Japan and listening to feedback from his peers, Dr. McGinn felt the procedure could be improved. Today, surgeons can have direct visibility of the aorta through the window incision allowing for proximal anastomosis to be performed on the aorta.

Q:
Is MICS CABG recommended for more complicated procedures such as double bypass, triple bypass, quadruple bypass and hybrid surgeries?

A:
In most cases the answer is yes, but the patient needs to be evaluated on an individual basis.