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MEDICAL ANIMATION TRANSCRIPT: During a conventional bypass surgery, your surgeon begins by making an incision in the skin over your breast bone or sternum. He or she will then cut the sternum and move your ribcage in order to get to your heart. Throughout the procedure, your circulatory system may be connected to a cardiopulmonary bypass pump or heart-lung machine. When the surgeon chooses to do the surgery without using the heart-lung machine, the heart continues to beat. This may be referred to as off-pump bypass surgery, or minimally invasive surgery. Instead, a mechanical device is used to steady the part of the heart where the grafting is being done. Surgeons perform minimally invasive bypass procedures using specially designed instruments inserted through small incisions or ports in the chest. more