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OBJECTIVE:
Minimally invasive coronary artery bypass (MICS) is performed through a small left lateral thorocotomy. Surgical approaches (sternotomy versus small thoracotomy) on postoperative pulmonary function were evaluated.
Methods:
Preoperative and postoperative (days 1- 6; 2 and 4 week; 6 months) pulmonary function were assessed in 49 patients undergoing MICS and were compared with 55 patients undergoing sternotomy for CABG.
Results:
The MICS group compared to sternotomy group did not show significance in surgical time, intubation period, and length of stay (Table). Pulmonary function test results were higher in MICS group for Forced Vital Capacity (FVC) compared to sternotomy and showed significance on postoperative day (POD) 1, 3, and 6 (POD1: 1.4L versus 1.0L, p=0.0081; POD3: 1.6L vs 1.2L, p= 0.0009; & POD6: 2.1L vs 1.4L p=0.049) MICS versus sternotomy: FEV1 (forced expiratory volume in 1 second) was significant on POD 1, 3, and 6 (p=0.0398, 0.008, & 0.0191, respectively). Both groups have similar volumes at 2 and 4 weeks and returned to baseline at 6 months.
Conclusions:
MICS CABG procedure leads to better preservation of pulmonary function postoperatively compared with sternotomy CABG.

Patient demographics and perioperative outcome.
	MICS	SD/%	Sternotomy	SD/%	P-Value
Pre-Operative	45		59
Age	64.1	±10.7	62.2	±9.1	0.3307
Gender (Male)	34	(75.6%)	51	86.4%	0.2019
Height (cm)	171.7	±7.8	173.3	±9.2	0.3508
Weight (kg)	85.6	±19.1	89.6	±17.3	0.2667
Diabetes	22	48.9%	27	45.8%	0.8435
Hypertension	40	88.9%	58	98.3%	0.0826
Current Smoker	10	22.2%	19	32.2%	0.2799
Chronic Lung Disease	8	17.70%	9	15.30%	0.7925
Ejection Fraction, %	45.2	±12.2	48.6	±13	0.1778
Congestive Heart Failure	7	15.9%	7	12.1%	0.7729
Peri-Operative
Extubated in OR	0	-	0	-	-
Intubation, hrs	10	±5	13	±32	0.9354
Prolonged Ventilation	0	-	1	4.5%	-
Surgery time, mins	246	±45	220	±55	0.727
Bypasses performed	2.56	±0.76	4.05	±1.11	0.0001
Pneumonia	0	-	0	-	-
Infection Sternum - Deep	0	-	0	-	-
Infection Thoracotomy	0	-	0	-	-
Atrial Fibrillation	9	69.2%	15	68.2%	0.6399
Re-intubated During Hospital Stay	0	-	1	1.8%	-
ICU Hours	107.7	±88.3	110.3	±85.1	0.9834
Length of Stay	5.42	±3.64	6.4	±3.9	0.1881