Patients should prepare in advance for a hospital stay of about three days. The patient is usually admitted on the scheduled date of the minimally invasive direct coronary artery bypass (MIDCAB). In the hospital, the patient will undergo a pre-operative assessment that includes:

Eight hours before surgery, all patients are placed on NPO (non per os; nothing by mouth) status. That means that they are not permitted to eat, drink or take anything by mouth until after their surgery. Smokers will have been instructed to completely avoid smoking for at least two weeks before their surgery to prevent problems in breathing, reduce secretions and facilitate necessary coughing. Certain medications may need to be reduced or stopped temporarily, so patients should discuss their medication schedules with their cardiologist before surgery.

Immediately before surgery, the patient will be given specific pre-operative medications and then “prepped” for surgery. First, the chest area is shaved. Next, the surgical team creates a sterile environment by swabbing the patient’s chest with an antiseptic solution and covering the operative area with sterile surgical drapes. An intravenous (I.V.) line will also be started, usually in the forearm or back of the hand.

The patient is then given a sleep-inducing medication through the I.V. line. Once asleep, the patient will continue to breathe a mixture of oxygen and anesthetic gas (general anesthesia) to make sure that he or she remains asleep throughout the entire surgery.