Application of lower median ministernotomy in coronary artery bypass grafting / 中国微创外科杂志

ABSTRACT

Objective To review the experience of 162 cases of coronary artery bypass grafting (CABG) via a lower median ministernotomy. Methods CABG through a lower median ministernotomy was conducted in 162 cases from April 1998 to June 2003, including 77 cases of CABG under extracorporeal circulation, 13 cases of CABG concomitant with intracardiac surgery, and 72 cases of off-pump coronary artery bypass grafting (OPCABG). Results There were 1 case of surgery-related death (0.6%) and 1 case of re-operation (0.6%). Postoperative complications occurred in 9 patients (5.6%). In conventional CABGs, the aortic cross-clamp time, cardiopulmonary bypass time, and operation time were 74.8?23.1 min, 113.6?31.3 min, and 255.5?54.5 min, respectively. The operation time of OPCABG was 195.6?50.6 min. The number of anastomoses ranged 1~5 (2.4?0.7). The length of postoperative tracheal intubation was 0~364 h (median, 11 h). The length of postanesthesia care unit (PACU) stay and hospital stay were 1~28 d (median, 3 d) and 5~60 d (median, 10 d), respectively. The chest drainage volume was 607.2?443.0 ml, or 8.6?6.0 ml/kg. A blood transfusion was required in 38 cases, with a transfusion amount of 1161.3?741.2 ml. Conclusions A less invasive approach is possible in coronary artery bypass grafting via a lower median ministernotomy. This procedure provides satisfactory outcomes and good cosmetic results, during which a complete revascularization for multiple vessels and concomitant intracardiac operations are available.