The Feasibility and Early Results of Multivessel Minimally Invasive Coronary Artery Bypass Grafting for All Comers

Abstract

Objectives: Cardiovascular surgery advancements have emerged with various minimally invasive approaches for treating multivessel coronary disease to improve outcomes and minimize the burden associated with conventional cardiac surgery. We present our clinical experience and minimally invasive coronary bypass techniques through minithoracotomy, which we apply without selection to patients who have decided to have elective surgery for multivessel isolated coronary artery disease. Methods: It consists of 230 consecutive patients operated by the same team with this method between July 2020 and September 2022. The patients were assigned to one of the two methods preoperatively to their accompanying comorbidities and operated on either with blood cardioplegia via 5 to 7 cm left anterior minithoracotomy, with on-pump clamped technique or without pump via left anterolateral minithoracotomy. Results: Mortality was observed in two of our patients (0.9%), but myocardial infarction was not observed in our patients in the early postoperative period. None of our patients required conversion to sternotomy (0%). Five patients’ needed reoperation from the same incision due to postoperative bleeding (2.2%), and atrial fibrillation developed in 17 patients in the postoperative period (7.4%). The mean number of bypasses was found to be 3.0 ± 0.9. Conclusions: Minimally invasive coronary artery bypass surgery via minithoracotomy can be routinely reproduced safely. More long-term results and more multicenter studies are needed for more widespread acceptance of the technique.

Minimally Invasive Isolated and Hybrid Surgical Revascularization for Multivessel Coronary Disease: A Single-Center Long-Term Follow-Up

“…An ongoing multicenter randomized trial will confirm the quality of life and recovery between MIDCAB and standard sternotomy CABG the MIST Trial [25]. This study will eventually corroborate the very good outcomes of Mid-CAB in the long term (more than 20 years) when performed in a carefully selected patient population [26][27][28]. Robotic iterations of this operation are already performed in leading centers worldwide, aiming to establish the maximal level of a true minimally invasive approach and providing good long-term outcomes in patients who are not candidates for conventional CABG [29].…”

The Efficacy of Minimally Invasive Coronary Artery Bypass Grafting (MICS CABG) for Patients with Coronary Artery Diseases and Diabetes: A Single Center Retrospective Study

“…Compared to CCABG, MICS CABG has stricter surgical contraindications, which mainly include severe peripheral artery disease, intolerance to unilateral pulmonary ventilation in Chronic Obstructive Pulmonary Disease (COPD), morbid obesity, thoracocyllosis, and severe calci cation of ascending aorta [13] . As a result, we conducted a more detailed preoperative evaluation of the MICS CABG group.…”