Experiences and lessons of minimally invasive single coronary artery bypass grafting——505 cases report in asingle institute / 中华胸心血管外科杂志

ABSTRACT

Objective:To discuss the indication, risk, postoperative complications and corresponding treatment strategies of minimally invasive coronary surgery.Methods:Reviewed 505 cases of minimally invasive single coronary artery bypass grafting completed in our center from November 2005 to March 2019, including 381 males(75.4%) and 124 females(24.6%). 479 cases were via left anterior small thoracotomy(MIDCAB), 21 cases were assisted by the Davinci system(RA-MIDCAB), and 5 cases were via distal mini-sternotomy(DIMS-CABG). Recorded and analyzed the patient's basic condition, surgical data, postoperative complications and treatment, and postoperative follow-up results.Results:7 cases of MIDCAB were converted into median sternotomy due to LIMA injury or pleural adhesion. Another 7 LIMA injury cases used RIMA or SVG anastomosed with LIMA to complete the revascularization. 6 cases underwent reoperation due to bleeding. 4 cases of postoperative myocardial infarction, 1 of which dead. 2 cases of stroke. 81 patients followed up with coronary CT or arteriography. And there were 8 occlusive grafts(9.88%). 405 patients completed telephone follow-up, all patients survived, good quality of life, no heart or cerebrovascular events.Conclusion:Minimally invasive single coronary artery bypass grafting is a safe and effective operation. Preoperative detailed assessment, careful operation during surgery, adequate contingency planning and reasonable response measures can further reduce the occurrence of complications.