Mics Multi-vessel Cabg In A Low Resource Country: Dare To Establish In Government Sector, My Experience.
Asraful Hoque, ABU SHADAT MOHAMMAD SAEM KHAN.
National Institution Of Cardiovascular Diseases, Dhaka, Bangladesh, DHAKA, Bangladesh.
BACKGROUND: MICS CABG is an advanced and safe option for multi-vessel coronary artery bypass. Ensuring both safety and quality as like open surgery, it provides several advantages over the traditional open surgery. Like any other minimally invasive operations, it provides quicker recovery, faster healing, less blood loss, less post operative pain, less wound infections and so on.
METHODS: A total of 75 patients were subjected to MICS CABG by a left minithoracotomy approach between 2021 and 2022. The left internal thoracic artery (LITA) harvesting, proximal, and distal anastomoses were performed under direct vision. The patients were underwent computed tomography coronary angiography (CTA) at 1 year of their follow up. The angiographic results were obtained for 44 (58.66%) patients at the end of their 1 year post operative period.
RESULTS: All patients undergone complete revascularization. Mean number of grafts were 2.8 ± 0.5. Conversion to sternotomy was needed for 1 (1.33%) patient. No perioperative mortality. All grafts were found patent at 1 year follow up on CTA.
CONCLUSIONS: In a low resource country like Bangladesh, especially in government sector, it is really difficult to establish the MICS program and run it successfully. But with the dedication and devotion of a group of young cardiac surgeons in National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, it has been proved possible ensuring the safety and quality of surgery among the poor patients seeking surgical treatment in this hospital.
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