Benefits and limitations of minimally invasive surgery in coronary revascularization: a systematic review

Coronary artery disease is one of the leading causes of mortality in the world, with treatments such as coronary artery bypass surgery seeking to restore arterial flow. Traditionally, this procedure is performed via sternotomy, with significant recovery times and risks. For this reason, minimally invasive surgery (MIDCAB) has emerged as a promising alternative, reducing complications. This work evaluates the benefits and limitations of MIDCAB. METHODS: A search was conducted in SCOPUS, PUBMED and SCIELO for studies published between 2020 and 2025, in Spanish and English, with open access, cohort and retrospective studies that addressed mortality rates, perioperative complications, hospitalization and recovery times. The final synthesis was based on 20 articles after filtering. RESULTS show that MIDCAB has low perioperative mortality rates (0.6%-3.5%) and limited complications, such as stroke (0%-2.3%) and perioperative myocardial infarction (0.6%-1, 6%). Hospitalization and recovery times were also shorter, with average ICU stays of 0.4 to 6.6 days. In the long term, MIDCAB showed a 10-year survival of 94.3%, highlighting its durability and effectiveness. CONCLUSION, MIDCAB represents a safe and effective option for coronary revascularization, especially in patients at high surgical risk or with limitations for more invasive procedures. However, the heterogeneity in the studies and the predominance of retrospective designs underscore the need for more robust prospective investigations to confirm these findings and guide clinical practice.