Marc Ruel · Decision guide

Marc Ruel: minimally invasive coronary bypass

Name: Marc Ruel: minimally invasive coronary bypass
Creator: Yevhenii Kozlov

Small-thoracotomy bypass with randomized recovery evidence · Ottawa, Canada

Research by Yevhenii Kozlov · Co-Founder of BookimedUpdated 8 October 2026Sources linked throughout

At a glance

Marc Ruel studies and performs minimally invasive coronary bypass at Ottawa Heart Institute. His work separates the short-term recovery effect of the incision from longer-term disease progression and repeat treatment.

A measured recovery benefit

In the 170-patient multicentre MIST trial, one-month SF-36 physical-component scores averaged 45.1 after MICS CABG versus 42.2 after sternotomy.

Sources: Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.

Trial eligibility matters

Participants were suitable for both approaches; previous cardiac surgery, unstable patients and combined procedures were excluded.

Sources: Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.

Longer-term coronary disease persists

In a separate 566-patient cohort with mean seven-year follow-up, 49 required repeat revascularization; native disease progression was the commonest reason.

Sources: Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?

Portrait source ↗

cardiac surgeon

Marc Ruel

University of Ottawa Heart Institute →

Professor; Endowed Chair and Director of Minimally Invasive Cardiac Surgery Research

Professor; Endowed Chair and Director of Minimally Invasive Cardiac Surgery Research · Ottawa, Canada.

Read the clinical or research source ↗

Reported surgical experience

1,000+ minimally invasive coronary bypass operations

Programme operations · Cumulative by April 2026; no start in numeric claim · published 2026-04-13 · counting date 2026-04-13

Minimally invasive coronary bypass operations.

50 years of heart: Innovation and teamwork transformed cardiac surgery ↗ · source read 2026-10-08

About 1,000 coronary bypass operations

Programme operations · Annual activity estimate published May 2025; calendar year not specified · published 2025-05-28 · counting date 2025-05-28

All CABG approaches.

The churro-inspired innovation that could transform bypass surgery ↗ · source read 2026-10-08

Compare coronary bypass experience →

Request a specialist assessment

Your diagnosis, selected specialist and treatment priorities.

Benefits and limitations

Potential advantages

For trial-eligible patients, MICS CABG improved the one-month patient-reported physical-recovery score relative to sternotomy.
Sources: Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.

Trade-offs and limits

MIST was conducted at seven centres by experienced teams and included 91% men. Neither it nor the observational follow-up establishes Ruel’s personal complication rate or lifelong superiority of a smaller incision.
Sources: Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial. · Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem? · Marc Ruel

Procedure-specific research

MIST: access compared in a randomized trial

Ruel was first author of MIST, which randomized 170 patients suitable for both approaches. MICS CABG improved the physical-recovery score at one month; no deaths or strokes occurred in either group through 12 months.

How to interpret this: Seven-centre trial with experienced teams; 91% were men. Previous cardiac surgery, unstable patients and concomitant procedures were excluded. It cannot establish long-term superiority or a personal complication rate.

Sources: Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.

Repeat treatment after MICS CABG

He coauthored follow-up of 566 patients, with mean follow-up of seven years. Repeat revascularization occurred in 49 patients; progression of native coronary disease was the most common reason.

How to interpret this: Single-institution observational follow-up. It does not compare randomized access strategies or isolate one surgeon’s results.

Sources: Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?

Clinical programme

University of Ottawa Heart Institute →

Ottawa, Canada

Ottawa’s CABG work includes both randomized evidence on the incision and observational evidence on later coronary treatment. The distinction is useful: faster early recovery does not prevent progression of disease in other native arteries.

Sources: Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial. · Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem? · Marc Ruel

Explore the programme and other specialists →

Continue your guide

Related heart surgery guides

University of Ottawa Heart Institute Specialists Compare surgeon expertise Coronary bypass Minimally invasive

Marc Ruel: minimally invasive coronary bypass

At a glance

A measured recovery benefit

Trial eligibility matters

Longer-term coronary disease persists

Marc Ruel

Reported surgical experience

Benefits and limitations

Potential advantages

Trade-offs and limits

Procedure-specific research

MIST: access compared in a randomized trial

Repeat treatment after MICS CABG

Clinical programme

University of Ottawa Heart Institute →

Related heart surgery guides

Turn information into your next step.