Minimally invasive coronary artery bypass grafting: dual-center experience in 450 consecutive patients.

Abstract:

BACKGROUND:Minimally invasive coronary artery bypass grafting (MICS CABG) is a novel coronary operation that does not require infrastructure and is potentially available to all cardiac surgeons. It aims at decreasing the invasiveness of conventional CABG while preserving the applicability and durability of surgical revascularization. We examined the feasibility and safety of MICS CABG in the first large series of this operation to date. METHODS AND RESULTS:All myocardial territories are accessed via a 4- to 6-cm left fifth intercostal thoracotomy. An apical positioner and epicardial stabilizer are introduced into the chest through the subxyphoid and left seventh intercostal spaces, respectively. The left internal thoracic artery is used to graft the left anterior descending artery, and radial artery or saphenous vein segments are used to graft the lateral and inferior myocardial territories. Proximal anastomoses are performed directly onto the aorta or from the left internal thoracic artery as a T-graft. In the first 450 consecutive MICS CABG procedures at our 2 centers, mean+/-SD age was 62.3+/-10.7 years and 123 patients were female (27%). The average number of grafts was 2.1+/-0.7, with complete revascularization in 95% of patients. There were 34 patients in whom cardiopulmonary bypass was used (7.6%), 17 conversions to sternotomy (3.8%), and 10 reinterventions for bleeding (2.2%). Perioperative mortality occurred in 6 patients (1.3%). CONCLUSIONS:MICS CABG is feasible and has excellent procedural and short-term outcomes. This operation could potentially make multivessel minimally invasive coronary surgery safe, effective, and more widely available.

journal_name

Circulation

journal_title

Circulation

authors

McGinn JT Jr,Usman S,Lapierre H,Pothula VR,Mesana TG,Ruel M

doi

10.1161/CIRCULATIONAHA.108.840041

subject

Has Abstract

pub_date

2009-09-15 00:00:00

pages

S78-84

issue

11 Suppl

eissn

0009-7322

issn

1524-4539

pii

120/11_suppl_1/S78

journal_volume

120

pub_type

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