{"schema_version":"bookimed.page-context.v1","id":"doctor-marc-ruel","url":"https://hub.bookimed.com/heart-surgery/doctor-marc-ruel/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-marc-ruel.json","index_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/index.json","full_dataset_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/content.json","content_revision":"source-driven-rankings-20261008","date_modified":"2026-10-08","language":"en","kind":"doctor-profile","title":"Marc Ruel: minimally invasive coronary bypass","summary":"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.","research_credit":{"name":"Yevhenii Kozlov","role":"Co-Founder of Bookimed","url":"https://us-uk.bookimed.com/ceo/kozlov/","contribution":"Research personally prepared and reviewed","assistance":"AI tools assisted source research."},"editorial_scope":"Source-based patient information; an individual treatment plan requires clinical review.","research_method":"How this guide is researched and compared Research project led by Yevhenii Kozlov . We link clinical guidance, primary studies and named hospital or offer sources beside the relevant statements. Comparisons distinguish individual operators from programme results and preserve the study population, follow-up and limitations. Prices are dated examples with their stated scope. Research and editorial preparation are separate from clinical review; no named clinician has medically reviewed this edition. Bookimed provides care coordination. Partner and reference programmes are identified from their sources; paid ordering is not used in our published-cohort comparison. Read the editorial policy .","key_takeaways":[{"label":"A measured recovery benefit","text":"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":["pd-adult-mist170"]},{"label":"Trial eligibility matters","text":"Participants were suitable for both approaches; previous cardiac surgery, unstable patients and combined procedures were excluded.","sources":["pd-adult-mist170"]},{"label":"Longer-term coronary disease persists","text":"In a separate 566-patient cohort with mean seven-year follow-up, 49 required repeat revascularization; native disease progression was the commonest reason.","sources":["pd-adult-ruel566"]}],"benefits":[{"text":"For trial-eligible patients, MICS CABG improved the one-month patient-reported physical-recovery score relative to sternotomy.","sources":["pd-adult-mist170"]}],"limitations":[{"text":"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":["pd-adult-mist170","pd-adult-ruel566","pd-adult-ruel-official"]}],"sections":[{"id":"benefit-balance","title":"Benefits and limitations","text":"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","links":[{"label":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/"},{"label":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/"},{"label":"Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?","url":"https://pubmed.ncbi.nlm.nih.gov/39603492/"},{"label":"Marc Ruel","url":"https://www.ottawaheart.ca/profile/ruel-marc"}]},{"id":"research","title":"Procedure-specific research","text":"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?","links":[{"label":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/"},{"label":"Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?","url":"https://pubmed.ncbi.nlm.nih.gov/39603492/"}]},{"id":"team","title":"Clinical programme","text":"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 →","links":[{"label":"University of Ottawa Heart Institute →","url":"https://hub.bookimed.com/heart-surgery/clinic-ottawa-heart/"},{"label":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/"},{"label":"Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?","url":"https://pubmed.ncbi.nlm.nih.gov/39603492/"},{"label":"Marc Ruel","url":"https://www.ottawaheart.ca/profile/ruel-marc"},{"label":"Explore the programme and other specialists →","url":"https://hub.bookimed.com/heart-surgery/clinic-ottawa-heart/"}]}],"introduction":"Heart surgery guide / Marc Ruel Marc Ruel · Decision guide Marc Ruel: minimally invasive coronary bypass Small-thoracotomy bypass with randomized recovery evidence · Ottawa, Canada Research by Yevhenii Kozlov · Co-Founder of Bookimed Updated 8 October 2026 Sources 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 →","related_documents":[{"id":"heart-surgery","title":"Heart surgery abroad: treatments, clinics and costs","kind":"home","url":"https://hub.bookimed.com/heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-surgery.json"},{"id":"coronary-bypass","title":"Coronary bypass surgery (CABG): options, teams and recovery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/coronary-bypass/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/coronary-bypass.json"},{"id":"minimally-invasive","title":"Minimally invasive and robotic heart surgery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/minimally-invasive/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/minimally-invasive.json"},{"id":"surgeons","title":"Find cardiac surgeons and heart specialists by procedure","kind":"surgeons","url":"https://hub.bookimed.com/heart-surgery/surgeons/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeons.json"},{"id":"surgeon-rankings","title":"Heart surgeon rankings by reported experience, method and results","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/surgeon-rankings/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeon-rankings.json"},{"id":"clinic-ottawa-heart","title":"University of Ottawa Heart Institute: heart surgery expertise","kind":"clinic-profile","url":"https://hub.bookimed.com/heart-surgery/clinic-ottawa-heart/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/clinic-ottawa-heart.json"},{"id":"coronary-bypass-surgeon-comparison","title":"Coronary bypass surgeon rankings: experience, methods and results","kind":"evidence-directory","url":"https://hub.bookimed.com/heart-surgery/coronary-bypass-surgeon-comparison/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/coronary-bypass-surgeon-comparison.json"}],"entity":{"id":"marc-ruel","name":"Marc Ruel","programme_id":"ottawa-heart","role":"Professor; Endowed Chair and Director of Minimally Invasive Cardiac Surgery Research","procedure_relevance":["Multivessel MICS CABG through a small thoracotomy; comparison with conventional sternotomy CABG."],"source_ids":["pd-adult-mist170","pd-adult-ruel566","pd-adult-ruel-official"],"official_url":"https://www.ottawaheart.ca/profile/ruel-marc","discipline":"cardiac surgeon","topic_slugs":["coronary-bypass","minimally-invasive","open-heart-surgery"],"profile":{"intro":"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.","clinical_focus":[{"label":"A measured recovery benefit","text":"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.","source_ids":["pd-adult-mist170"]},{"label":"Trial eligibility matters","text":"Participants were suitable for both approaches; previous cardiac surgery, unstable patients and combined procedures were excluded.","source_ids":["pd-adult-mist170"]},{"label":"Longer-term coronary disease persists","text":"In a separate 566-patient cohort with mean seven-year follow-up, 49 required repeat revascularization; native disease progression was the commonest reason.","source_ids":["pd-adult-ruel566"]}],"evidence":[{"title":"MIST: access compared in a randomized trial","summary":"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.","limitations":"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.","source_ids":["pd-adult-mist170"]},{"title":"Repeat treatment after MICS CABG","summary":"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.","limitations":"Single-institution observational follow-up. It does not compare randomized access strategies or isolate one surgeon’s results.","source_ids":["pd-adult-ruel566"]}],"consultation_questions":[],"current_role_note":"Professor; Endowed Chair and Director of Minimally Invasive Cardiac Surgery Research · Ottawa, Canada.","key_takeaways":[{"label":"A measured recovery benefit","text":"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":["pd-adult-mist170"]},{"label":"Trial eligibility matters","text":"Participants were suitable for both approaches; previous cardiac surgery, unstable patients and combined procedures were excluded.","sources":["pd-adult-mist170"]},{"label":"Longer-term coronary disease persists","text":"In a separate 566-patient cohort with mean seven-year follow-up, 49 required repeat revascularization; native disease progression was the commonest reason.","sources":["pd-adult-ruel566"]}],"benefits":[{"text":"For trial-eligible patients, MICS CABG improved the one-month patient-reported physical-recovery score relative to sternotomy.","sources":["pd-adult-mist170"]}],"limitations":[{"text":"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":["pd-adult-mist170","pd-adult-ruel566","pd-adult-ruel-official"]}],"patient_sections":[{"id":"benefit-balance","title":"Benefits and limitations","paragraphs":[],"items":[],"sources":[],"kind":"benefit-balance","links":[],"table":null},{"id":"research","title":"Procedure-specific research","paragraphs":[],"items":[],"sources":[],"kind":"doctor-evidence","links":[],"table":null},{"id":"team","title":"Clinical programme","paragraphs":[],"items":[],"sources":[],"kind":"doctor-clinic","links":[],"table":null}]},"photo_candidate":{"url":"https://www.ottawaheart.ca/sites/default/files/styles/1_1_scale_and_crop_small/public/legacy/images/profiles/dr-marc-ruel-uohi_1.jpg?h=6543e6c1&itok=YhGW2c9P","source_page":"https://www.ottawaheart.ca/profile/ruel-marc","alt":"Portrait of Marc Ruel","source_alt":"Dr. Marc Ruel, UOHI","provenance":"URL observed on official page; image bytes not downloaded; coordinator to inspect before use.","width":660,"height":660},"topics":["cabg","minimal"],"headline":"minimally invasive coronary bypass","profile_slug":"doctor-marc-ruel","portrait":{"url":"https://hub.bookimed.com/wp-content/uploads/2026/10/marc-ruel-300x300.jpg","source_page":"https://www.ottawaheart.ca/profile/ruel-marc","width":660,"height":660,"alt":"Portrait of Marc Ruel"}},"ranking":{"engine_version":"reported-volume-v1","facts_digest":"b2057ed11422aaf9ecbef7849da5e5c2be583ed36f70e64a8a183767f7154fef","calculated_at":"2026-10-08","facts":[{"id":"ottawa-mics-cabg-2026","provider_id":"marc-ruel","family":"cabg","subject_scope":"programme","measurement":"cumulative","procedure":"mics_cabg","inclusion_scope":"isolated-and-combined","value":1000,"relation":"more_than","display":"1,000+","unit":"Minimally invasive coronary bypass operations","period_label":"Cumulative by April 2026; no start in numeric claim","reported_as_of":"2026-04-13","method":"Minimally invasive coronary bypass operations. 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","source_url":"https://www.ottawaheart.ca/the-beat/news/50-years-heart-innovation-and-teamwork-transformed-cardiac-surgery"}]}],"providers":[{"id":"marc-ruel","name":"Marc Ruel","clinic_id":"ottawa-heart","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-marc-ruel.json"}],"excluded":[{"fact_id":"ottawa-cabg-annual-rate-2025","reason":"study or non-calendar period"}],"default_views":{},"coverage":[{"provider_id":"marc-ruel","family":"cabg","gaps":["Exact calendar-year MICS CABG count","Ruel personal cumulative or annual CABG count"],"source_ids":[],"unresolved_source_ids":["rs-ottawa-mics-2026","rs-ottawa-cabg-annual-2025"]}]},"sources":{"cabg-ottawa566":{"id":"cabg-ottawa566","title":"Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?","url":"https://pubmed.ncbi.nlm.nih.gov/39603492/","doi":"10.1016/j.jtcvs.2024.11.020","publication_year":2025,"online_year":2024,"source_kind":"primary_single_centre_longitudinal_cohort","body_access":"primary_abstract_read_via_Europe_PMC","support_location":"Methods and Results","short_excerpt":"Clinical follow-up was complete for 100% of patients","read_at":"2026-10-07","source_type":"primary_single_centre_longitudinal_cohort"},"cabg-mist170":{"id":"cabg-mist170","title":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/","doi":"10.1016/S0140-6736(26)01288-2","publication_year":2026,"source_kind":"primary_multicentre_randomized_trial","body_access":"complete_original_abstract_read_via_Europe_PMC","support_location":"Methods and Findings; July31 online/August22 print2026","short_excerpt":"The primary endpoint was patient-reported physical recovery at 1 month","read_at":"2026-10-08","source_type":"primary_multicentre_randomized_trial","body_file":"sources/mist.json","access_limit":"Publisher full article is subscription-only; only original abstract used. No claims about unreported subgroup outcomes or long-term graft patency."},"cabg-ruel-current":{"id":"cabg-ruel-current","title":"Ruel, Marc — University of Ottawa Heart Institute","url":"https://www.ottawaheart.ca/profile/ruel-marc","source_kind":"official_current_hospital_profile","body_access":"search_returned_substantial_page_body_read","support_location":"Appointments and affiliations; Background; current2026 MIST paragraph","short_excerpt":"director of minimally invasive cardiac surgery research","read_at":"2026-10-07","source_type":"official_current_hospital_profile"},"pd-adult-ruel-official":{"title":"Marc Ruel","publisher":"University of Ottawa Heart Institute","url":"https://www.ottawaheart.ca/profile/ruel-marc","read_at":"2026-10-08","kind":"official provider or programme page","support":"Current professor and endowed chair/director of minimally invasive cardiac surgery research; former division chief.","limitations":"An institutional listing supports current role and stated clinical scope; it does not establish the next appointment, operating allocation or individual risk-adjusted results.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/ruel-official.txt"},"pd-adult-ruel566":{"title":"Revascularization after minimally invasive coronary artery bypass grafting in 566 patients: Is it a problem?","publisher":"The Journal of thoracic and cardiovascular surgery","url":"https://pubmed.ncbi.nlm.nih.gov/39603492/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/ruel566.json","published_at":"2024-11-25","doi":"10.1016/j.jtcvs.2024.11.020","authors":"Toubar O, Guo MH, Ashenhurst C, Ponnambalam M, Glineur D, Ruel M."},"pd-adult-mist170":{"title":"Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial.","publisher":"Lancet (London, England)","url":"https://pubmed.ncbi.nlm.nih.gov/42537680/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/mist170.json","published_at":"2026-07-31","doi":"10.1016/s0140-6736(26)01288-2","authors":"Ruel M, Nambala S, Guo MH, Verevkin A, Rabindranauth P, Kikuchi K, Davierwala PM, Lemma M, Ponnambalam M, Sheikh A, Black A, Borger MA, Whitlock RP, Zhang Y, Wells GA."},"volume-ottawa-mics-cabg-2026":{"id":"volume-ottawa-mics-cabg-2026","title":"50 years of heart: Innovation and teamwork transformed cardiac surgery","url":"https://www.ottawaheart.ca/the-beat/news/50-years-heart-innovation-and-teamwork-transformed-cardiac-surgery","publisher":"Institution / clinical programme","published":"2026-04-13","read_at":"2026-10-08","source_type":"Reported clinical activity; scope shown with figure"},"volume-ottawa-cabg-annual-rate-2025":{"id":"volume-ottawa-cabg-annual-rate-2025","title":"The churro-inspired innovation that could transform bypass surgery","url":"https://www.ottawaheart.ca/the-beat/news/the-churro-inspired-innovation-could-transform-bypass-surgery","publisher":"Institution / clinical programme","published":"2025-05-28","read_at":"2026-10-08","source_type":"Reported clinical activity; scope shown with figure"}}}