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Coronary bypass is the most exhaustively studied operation in the history of surgery, and it has achieved widespread use because its benefits have been so thoroughly documented. Yet the dominance of coronary bypass is being threatened by the success of interventional cardiology. The need to reduce the discomfort, morbidity, and costs associated with conventional cardiac surgery has led surgeons to explore various "minimally invasive" approaches, such as minimally invasive direct coronary-artery bypass (MIDCAB), in which coronary bypass (usually with a single graft) is performed on the beating heart without the heartlung machine and through a small incision; off-pump coronary-artery bypass
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