Common cardiac surgical procedures: bypass, valve repair and replacement

Cardiac surgery has undergone profound changes since Ludwig Rehn successfully repaired a right ventricular stab wound in 1896. The following century saw the rapid development of open-heart surgery, with minimally invasive surgical approaches following suit. Traditionally, sternotomy has been the incision of choice for cardiac surgical procedures, but technological advances have been applied to develop non-sternotomy, video-assisted thoracoscopic surgery (VATS) and robotic approaches. Parallel to surgical innovation, percutaneous coronary intervention (PCI) and transcatheter valve replacement procedures have offered important alternatives to surgery, currently reserved for specific patient subgroups. Despite the availability of catheter-based techniques, cardiac surgery remains relevant to the majority of our patients presenting with coronary artery disease or valvular pathologies and therefore coronary artery bypass graft (CABG) surgery and surgical valve replacement constitute a substantial part of our daily practice. In this article we discuss the relevance of surgical options and highlight the most up-to-date surgical techniques and innovations, with a focus on the advances of minimally invasive cardiac surgery.