Early and Mid-Term Results of MIDCAB

Son, Ho Sung; Sun, Kyung; Fang, Young Ho; Hwang, Znuke; MIn, Byoung Ju; Jo, Yang Hyun; Park, Sung Min; Lee, Sung Ho; Kim, Kwang Taik

Abstract

BACKGROUND: The significance of MIDCAB is emerging topics recently as OPCAB is going to be universalized, and long-term outcome of bypass graft surgery was proved to be more excellent than balloon dilation or stent insertion. We report our MIDCAB results in 73 patients in the last three years. MATERIAL AND METHOD: Retrospective analysis of medical records was done from November 1, 2000 through November 31, 2003. There were 47 males and 26 females ranging in age from 31 years to 79 years (average 61.3+/-9.8 years). Observation periods after operative procedures were 10 to 1238 days (average 763+/-319.8 days). Left longitudinal parasternal incision as a standard procedure was done to approach the heart after dissection of the left internal thoracic artery by partial or total resection of 3rd to 5th ribs. RESULT: Of those patients, 46 patients were transferred to ICU after extubation at operation room and 58 patients were extubated within 3 hours after operation. Average ICU staying periods was 26.8+/-11.5 hours. Follow-up angiography during admission was done in 36 patients and showed 100% patency. Only one patient died on the 10th post operative day because of sudden CVA. Complications included wound problems in 4 patients, and constructing pericardial window using thoracoscopy due to continuous pericardial effusion in 1. Permanent pacemaker was inserted in one patient owing to sick sinus syndrome. In one patient with recurrence of angina 8 months after operation, stenosis at anastomic site was found and improved with balloon dilatation.
CONCLUSION
We were satisfied with our results of MIDCAB in single and multi-vessel coronary artery disease. These results have made the cardiologists tried to operate positively and we expect widening operative indications including hybrid revascularization.