View with images and charts EARLY EVALUATION OF PULMONARY FUNCTIONS OF PATIENTS WITH MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS GRAFT SURGERY An Overview: Despite the technical improvement in the management of cardiac surgery, pulmonary function following cardiac surgery is still a challenge for cardiac surgeons. This topic was and still is being studied. This is an attempt to address this fascinating, and vital issue, within the constraints prevailing here. In our country, patients with coronary artery disease are referred to this institute. A significant number of patients are managed in NICVD. A total of 750 patients were operated in NICVD in the year 2007, out of which 265 were CABG, 60 of which were MIDCAB procedure and remaining were conventional on-pump procedure CABG. So far only one study was done to evaluate pulmonary function after on-pump CABG. No comparative study was done on pulmonary outcomes between MIDCAB and conventional on-pump CABG procedure. In this study, we have tried to evaluate pulmonary outcomes after CABG surgery and to compare the incidence between MIDCAB and conventional on-pump CABG procedure. Recently, a variety of Novel approaches and ingenious techniques have been developed in an attempt to make cardiac surgical procedures less invasive. Many of these methods remains largely experimental, Yet one procedure seems to have been rapidly accepted by Cardiac surgeon. MIDCAB Stands for a less invasive procedure because here three component of invasive nature like (a) Cardio pulmonary bypass. (b) Sternotomy and (c) aortic manipulation are obviated (Izzat and Yim, 1997). MIDCAB was developed as a less invasive approach toward bypass surgery. Because a smaller incision is used, patients recover more quickly, with less trauma and short time as compared to conventional CABG. Recovery time after MIDCAB is comparable to recovery time after balloon angioplasty (3 to 7 days) versus the two weeks that are common after conventional CABG. Within two weeks, many MIDCAB patients can return to normal activities (Elhendy et al., 2007). Regardless of the recent advances in technology with cardiopulmonary bypass (CPB), postoperative pulmonary dysfunction continues to be an important cause of morbidity. Although severe postoperative acute