Minimally Invasive Bypass Surgery on a Beating Heart
A Medical Revolution by Dr. Danko Grujić: Heart Surgery Without Opening the Chest
Minimally invasive bypass on a beating heart:
The World Standard in the Hands of Dr. Danko Grujić
Dr. Danko Grujić, a subspecialist in cardiothoracic surgery at the University Clinical Center of Serbia, is recognized as pioneer of minimally invasive bypass surgery in the region. Trained by world-renowned expert Prof. Alexander Albert of Dortmund, Dr. Grujić was the first in Serbia to introduce a method that is changing the future of heart treatment.
Unlike traditional approaches, the heart surgery without opening the chest performed by Dr. Grujić is carried out through a small incision of only 4–5 cm on the left side of the chest.
Beating heart bypass
The operation is being performed. without stopping the heart, without manipulating the ascending aorta, and without the use of a heart-lung machine, which directly reduces operational risk.
The use of Arterial Grafts
This method is performed Complete myocardial revascularization. Only arteries that are scientifically proven to be the most long-lasting solution for revascularization are used.
Intraoperative TTFM verification of bypass grafts – objective quality control
In modern minimally invasive coronary bypass surgery, Technical precision of anastomosis directly determines the outcome of the operation. That is why during every procedure we apply Intraoperative verification of grafts by ultrasound Transit-Time Flow Measurement (TTFM).
This technology allows for a quantitative assessment of the functionality of each graft immediately upon completion of the anastomosis, while the patient is still on the operating table. It is documented for every patient who undergoes surgery and is also part of their medical record.
“The doctor gave me a second chance at life.”
In September 2024, Dr. Danko Grujić performed a five-vessel arterial bypass on a beating heart using an exclusively
Education
As an internationally recognized proctor and leader in the field of cardiothoracic surgery, Dr. Danko Grujić Regularly conducts training for foreign surgeons from Germany, Sweden, and Greece in its application. minimally invasive bypass
Thanks to these innovations and success with over 400 operated patients, Serbia has become an educational center for Bypass on a beating heart, attracting experts from all over the world
June 10, 2022 – The date that changed Serbian cardiac surgery: The first minimally invasive bypass surgery in Serbia with the assistance of Prof. Alexander Albert.
Right-MIDCAB
Right-MIDCAB is one of the variations of the minimally invasive bypass procedure, and one technique by which this approach differs from classical surgery. This approach can also treat isolated single-vessel diseases of the left or right coronary system, which are not otherwise the subject of open surgery.
It is reserved only for centers with extensive expertise in the minimally invasive treatment of coronary disease. They are performed in only two cardiac surgery centers in the world, in Toronto and Frankfurt.
Dr. Danko Grujić and his team have introduced this procedure into our practice, allowing a group of patients to be treated in a way that yields the best long-term results., and at the same time leaves the option for patients that if the left coronary system disease develops, they can be treated with the standard minimally invasive approach from the left side of the chest.
Frequently Asked Questions
What is the main difference between classic and MICS CABG bypass?
The main difference is in the approach to the heart and the actual course of the operation. In a classic bypass, the sternum is completely cut, and the heart is often stopped using a heart-lung machine.
Who can be candidates for MICS CABG surgery?
Anyone can be a candidate for this minimally invasive type of surgical revascularization. Patients requiring surgical myocardial revascularization by decision of the medical board, except for emergencies and hemodynamically unstable patients requiring urgent cardiac surgical revascularization.
What are the indications for MICS CABG surgery?
Indications are complete andas for a classic operation, that is, all patients who are candidates for bypass surgery by the classic method, can be operated on using a minimally invasive procedure, regardless of whether they need one, two, three, or even five bypass grafts. In fact, with this approach, andThe indication was also expanded to include certain conditions that are not the subject of open bypass surgery., Patients with isolated disease of the right or left coronary system, which could not be resolved with a stent, can be operated on using this less invasive method, with excellent long-term results.
What arterial grafts are used in MICS CABG operations?
In minimally invasive operations, the left and right internal thoracic artery (mammary artery) are standardly used as first-choice grafts and the gold standard in cardiac surgical revascularization. Left and right radial arteries are used as second-choice grafts, and as one of the few clinics in the world in this type of surgery, the left gastroepiploic artery from the stomach, as well as the inferior epigastric artery from the anterior abdominal wall, have been used.
How long is the recovery after a MICS CABG procedure?
One of the greatest advantages of this procedure is the extremely fast return to daily life. While classic surgery requires a months-long recovery due to the healing of the sternum, with the minimally invasive method, patients stay in the hospital for an average of only 4 days.
Why is TTFM so significant?
Clinical studies have shown that about 3-7% of sutured anastomoses may have a technical problem that requires immediate revision.
This means that without intraoperative control, a significant number of grafts could remain with:
- suboptimal flow
- Technical anastomotic stenosis
- by torsion or kinking of the graft leading to hemodynamically inadequate myocardial perfusion.
Does Dr. Danko Grujić train foreign specialists?
Yes, Dr. Danko Grujić is a recognized international proctor and educator in the field. minimally invasive bypass
More than half of patients awakened already on the operating table
Patient Testimonials
„When my coronary angiography was done, it was determined that my coronary arteries were seriously blocked and that emergency surgery was necessary. That is how I came to Dr. Danko Grujić. Until then I didn't know him nor had I heard of him before, and I recommend it to everyone today.
Dr. Grujić is first and foremost an exceptional man, and then top expert. I underwent a quintuple open-heart bypass, a very complex operation which, thanks to him and his team, went successfully.
The recovery was extraordinary. Already after the removal of the stitches, I was able to independently perform everyday activities, mow the lawn, trim the hedge, and function without pain or discomfort.
I am immensely grateful to Dr. Danko Grujić for his expertise, dedication, and everything he has done for me. I wholeheartedly recommend him to everyone. Hats off to you, doctor!“
„Fantastic experience with the doctor. They told me to go home by ambulance, but I drove myself home because I felt so good! I could sit normally after the surgery and sit in the car without any problems. Two days after the surgery, I was already walking around the yard.„
From the patient to the return to the operating room. Dr. Moljević is in the first photograph just 10 days after beating-heart bypass surgery, while the second one, taken only three weeks later, shows him back in the role of a surgeon – during a total hip arthroplasty operation.
Patient recovery 2 weeks after surgery
Watch the highlights
Dr. Danko Grujić, cardiac surgeon, presented a minimally invasive bypass technique at the Gregorio Marañón University Hospital in Madrid
Madrid, July 2026. At the invitation of colleagues from the Clinic for Cardiovascular Surgery at the Gregorio Marañón University Hospital in Madrid, one of the largest and most reputable hospitals in Spain, Dr. Danko Grujić paid a professional visit during which he gave a lecture and performed a minimal...
ISMICS Annual Scientific Meeting, Miami – June 2026.
Lecture at ISMICS Annual Scientific Meeting, Miami – June 2026. At the annual meeting of the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS), held in June 2026 in Miami, Florida, an original case of the triple inflow technique was presented in...
International Coronary Congress (ICC), New York – December 2025.
Lecture at the International Coronary Congress (ICC), New York – December 2025. At the International Coronary Congress (ICC) in New York, the world's most significant congress dedicated to coronary surgery, Dr. Danko Grujić gave a lecture on his experience in minimally invasive...
Contact
As an educator and proctor who trains surgeons throughout Europe, Dr. Danko Grujić applies the most modern protocols in the treatment of coronary disease