Korean J Thorac Cardiovasc Surg.  2018 Feb;51(1):8-14. 10.5090/kjtcs.2018.51.1.8.

Mid-Term Results of Minimally Invasive Direct Coronary Artery Bypass Grafting

• Seo DH
• Kim JS
• Park KH
• Lim C
• Chung SR
• Kim DJ

• KMID: 2409707
• DOI: http://doi.org/10.5090/kjtcs.2018.51.1.8

Abstract

BACKGROUND
Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients.
METHODS
All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data"”including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention"”were collected.
RESULTS
The mean age of the patients was 69.4±11.1 years and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in the intensive care unit and in the hospital were 1.5 and 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of 85.3%±0.09% and a 5-year MACCE-free survival rate of 72.8%±0.1%. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at 9.7±10.8 months postoperatively.
CONCLUSION
MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.

Keyword

Coronary artery disease; Coronary artery bypass; Minimally invasive surgery

MeSH Terms

Angiography
Arteries
Coronary Angiography
Coronary Artery Bypass*
Coronary Artery Disease
Coronary Vessels*
Follow-Up Studies
Hemorrhage
Humans
Intensive Care Units
Male
Minimally Invasive Surgical Procedures
Mortality
Operating Rooms
Sternotomy
Stroke
Survival Rate
Thoracotomy
Transplants