Minimally invasive direct coronary artery bypass for left anterior descending artery revascularization – analysis of 300 cases

Lufeng Zhang; Zhongqi Cui; Zhiming Song; Hang Yang; Yuanhao Fu; Yichen Gong; Yunpeng Ling

doi:10.5114/wiitm.2015.55842

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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4/2015
vol. 10

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abstract:

Original paper

Minimally invasive direct coronary artery bypass for left anterior descending artery revascularization – analysis of 300 cases

Lufeng Zhang

,

Zhongqi Cui

,

Zhiming Song

,

Hang Yang

,

Yuanhao Fu

,

Yichen Gong

,

Yunpeng Ling

Videosurgery Miniinv 2015; 10 (4): 548–554

DOI: https://doi.org/10.5114/wiitm.2015.55842

Online publish date: 2015/11/30

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Introduction: Minimally invasive direct coronary artery bypass (MIDCAB) grafting is performed via small, left anterolateral thoracotomy. The left internal mammary artery was grafted to the left anterior descending (LAD) artery in 300 consecutive patients.

Aim: In-hospital results were evaluated and compared with the conventional, off-pump coronary artery bypass graft procedure.

Material and methods: One hundred and sixty-three (54.33%) of 300 patients underwent staged hybrid coronary revascularization, 93 (31%) were treated for a single LAD lesion, and 44 (14.67%) were treated for multi-vessel disease with reasonably incomplete revascularization. Major in-hospital cardiac adverse events and postoperative data were compared between groups.

Results: Preoperative data were similar between groups. However, the difference in left ventricular ejection fraction (p < 0.001) was significant. No conversions to sternotomy occurred during the primary MIDCAB procedures. Shorter operation time (p < 0.001), shorter postoperative mechanical ventilation time (p < 0.001), shorter intensive care unit stay (p < 0.001), and less red blood cell transfusion (p < 0.001) were noted in the MIDCAB group. Postoperative coronary angiography conducted in the MIDCAB group within one week after the operation showed that 2 of 163 patients developed graft occlusion. These patients underwent conventional CABG and recovered well. No significant differences were observed in postoperative MI, delayed wound healing or 30-day in-hospital mortality between the two groups.

Conclusions: The use of a chest wall lifting system and modified stabilizer makes the MIDCAB procedure safer and easier. The MIDCAB procedure is demonstrated to be a feasible and minimally invasive alternative for patients with coronary artery disease involving LAD lesions.

keywords:

Minimally invasive direct coronary artery bypass for left anterior descending artery revascularization – analysis of 300 cases

Lufeng Zhang , Zhongqi Cui , Zhiming Song , Hang Yang , Yuanhao Fu , Yichen Gong , Yunpeng Ling

coronary artery bypass grafts surgery, off-pump surgery, minimally invasive surgery

Lufeng Zhang

,

Zhongqi Cui

,

Zhiming Song

,

Hang Yang

,

Yuanhao Fu

,

Yichen Gong

,

Yunpeng Ling