The Safety And Efficacy Of Minimally Invasive Coronary Artery Bypass Grafting
Fatih Gumus1, Mustafa Serkan Durdu2.
1Bartin State Hospital, Bartin, Turkey, 2Ankara University, Ankara, Turkey.
Background: To examine the safety and efficacy of minimally invasive coronary artery bypass grafting (MICS-CABG) and compare the results with traditional open-heart CABG. Methods: From the first case in January 2018 to December 2021, a total of 42 cases of MICS-CABG (group 1) and 154 cases of CABG with sternotomy (group 2) were performed in our center. The operations of MICS-CABG were performed via the 5(th) intercostal space of left thoracic lateral incision under on-pump, with the help of the chest wall suspension device and cardiac fixator. The preoperative clinical data and perioperative complications of the patients were collected, and main adverse cardiovascular and cerebrovascular events (MACCE) were followed up and we compared the results between two groups. We assessed the quality of life of all patients with SF-36 questionnaire at 1 month follow-up. Results: There were 96 males and 100 females, aging (64.2±6.9)years (range: 41 to 81 years). There was no significant difference between the groups regarding to preoperative clinical data. Complete revascularization was achieved in 98.9% of patients, with a mean of 2.2 ± 0.6 grafts. In group 1, only 2 patients had transition to sternotomy due to uncontrolled bleeding. 2 cases from group 2, 1 case from group 1 needed intra aortic balloon pumping during the operation. The MICS CABG group also had less wound infection than group 2 (2.3% vs. 9.1%, respectively). The rate of MACCE in 30 days was 4.08% (8 cases), which contained 4 cases of death (3 cases of grafts occlusion, 1 case of serious hemorrhage after thoracic puncture drainage), 4 cases of stroke. At 1 month follow up, CABG group significantly lower SF-36 score (−7.7 ± 0.9, p < .001) compared to the MICS-CABG group, which reflects the invasiveness of sternotomy CABG.Conclusions: MICS-CABG can safely achieve completed revascularization, which has good operative effects in short and medium-long term. There is no significant risk in the early cases of learning curve comparing to standart surgical approach.
Back to 2022 Display ePosters