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OBJECTIVE:
Off-pump myocardial revascularization allows improved results of coronary artery revascularization regarding mortality and neurological outcome. Similar to other cardiac procedures, a minimally invasive approach for this procedure has been developed within the last years. Although only few reports about this technique are published yet, the post-operative outcome and the quality of life of the patients are expected to be beneficial. This study demonstrates the early in hospital results and the results of the SF-36 survey of the first 181 patients who received an off-pump myocardial revascularization via an antero-lateral mini-thoracotomy in our hospital.
METHODS:
Between August 2008 and November 2011 181 patients underwent minimally invasive off-pump myocardial revascularization. In all patients the left internal mammary artery (LIMA) and one endoscopically harvested radial artery were used. After the mini-thoracotomy in the fourth intercostal space, we performed a total arterial revascularization to all target areas. Patients with only single IMA revascularization were excluded. A mean of 2.2 distal coronary anastomoses were performed to all three regions of the heart (anterior 177 pat., lateral 108 pat., posterior 26 pat.) A SF-36 questionnaire was given to the patients pre- and on average of 12 months post-operatively.
RESULTS:
There was no hospital as well as 30-days-mortality, no post-operative myocardial infarction and no cerebrovascular stroke, respectively. In the SF-36 survey, the patients showed a significant improvement regarding physical functioning, role physical, bodily pain, vitality and social functioning. No patient reported a myocardial infarction or a cerebrovascular accident after been discharged from our hospital.
CONCLUSIONS:
The minimally invasive off-pump myocardial revascularization via an antero-lateral mini-thoracotomy is a safe and feasible procedure. It leads to a significant post-operative improvement in the quality of life.