International Society For Minimally Invasive Cardiothoracic Surgery

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Facilitating Complex Procedures In Off Pump Coronary Bypass Grafting
Pascal Starinieri1, Silke Van Genechten1, Boris Robic2, Alaaddin Yilmaz1.
1Jessa Hospital, Hasselt, Belgium, 2University Medical Centre Maribor, Maribor, Slovenia.

BackgroundIn an attempt to decrease the drawbacks of conventional sternotomy, minimal invasive cardiac surgery (MICS) was developed. Off-pump coronary artery bypass surgery has been proven to be successful but still experiences some peri-operative difficulties. To facilitate and to overcome these type of difficulties, minimal invasive extracorporeal circulation (MiECC) can be a useful tool.
MethodsFrom January 2014 until November 2018, one hundred thirty patients were being operated with the use of MiECC without aortic cross-clamp and compared to 155 patients treated with an off-pump technique. Prospective collected retrospective data from both groups was analysed. Minimal invasive arterial coronary bypass surgery with thoracoscopic harvesting of the internal mammary artery was achieved in both groups.
ResultsSignificant differences in perioperative blood loss (P = <.001) and inflammation (P = <.05) were seen in favour of the off-pump group. No significant differences were shown regarding hospital stay (P = .11) and ICU stay (P = .73) but more distal anastomoses could be performed in the MiECC group (P = <.001).
ConclusionMiECC provides a good alternative for complex minimal invasive coronary bypass procedures avoiding the deleterious effects of conventional bypass circuits. Short-term differences in collected data were seen regarding inflammation and perioperative blood loss. More distal anastomoses could be performed which could benefit long-term results.

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