Early experience of minimally invasive coronary surgery with bilateral internal mammary artery / 中华胸心血管外科杂志

ABSTRACT

Objective:To investigate the early clinical outcomes and experience of minimally invasive coronary surgery-bilateral internal mammary artery(MICS-BIMA) through the left anterior small incision.Methods:132 consecutive patients with 2-vessel disease receiving off-pump coronary artery bypass surgery from October 2015 to June 2019 were enrolled in this study, 20 of which performed MICS-BIMA while 112 cases the routine OPCAB through median sternal incision. Propensity Score Match was used to balance the two groups with the ratio of 1∶3, 60 cases selected as the control group from OPCAB in consequence. After the match, two groups were compared in terms of the baseline and the perioperative data. The conduit patency was evaluated in MICS-BIMA group.Results:No statistically significant difference was shown in the baseline between the two groups( P>0.05). The operation time in MICS-BIMA group was longer than that in OPCAB group[(256.0±57.7)min vs.(227.8±46.8) min, t=2.20, P=0.03)], and the postopende hospital stag nas colso short(nedim 7 days vs. medion 10 ays, P=0.002), the differences were statistically signific cint.. The perioperative blood transfusion in MICS-BIMA group seemed less, though no significant difference was performed between the two groups[(0.5±1.2)U vs.(1.1±2.0)U, t=10.0, P=0.072]. There were no differences in MACCE, perioperative IABP use and wound infection between the two groups( P>0.05). In MICS-BIMA group, 40 IMA grafts from 20 patients were performed, with 8 in-situ grafts and 12 Y-graft. Except from LAD in all cases, 10 Diagonals, 4 RAMUSs, 4 OM/LCXs, 1 RCA and 1 PDA were bypassed. Operative angiography by CT scan showed a good patency of BIMA in MICS-BIMA group. Conclusion:Minimally invasive coronary surgery with bilateral internal mammary artery is a safe and effective approach for 2-vessel disease. Satisfied early clinical outcomes were shown in the study.