Early results and mid-term patency of minimally invasive direct coronary bypass grafting surgery / 中华胸心血管外科杂志

ABSTRACT

Objective To study the early clinical outcome of patients undergone minimally invasive direct coronary bypass(MIDCAB) surgery,and the mid-term patency of left internal mammary artery(LIMA)-left anterior descending(LAD) anastomosis.Methods From Jannuary 2007 to May 2014,47 cases underwent MIDCAB surgery in our department,with 35 males and 12 females,aged 48-76 years,with the average of (62.9 ± 8.1) years old.Types of LAD lesions were as followed1 case was ostial total obstruction,28 severe stenosis at proximal segment,10 long and severe stenosis,3 calcified lesion with severe stenosis,5 myocardial bridge.All patients had symptomatic angina,typical myocardial ischemia could be detected by electrocardiogram for all patients with myocardial bridge.Comorbidities includedhypertension 38 cases,27 diabetes mellitus,3 COPD and 3 chronic kidney disease.Results All surgery went well without transfer to mid-sternotomy.LIMA harvest time was 38-53 minutes,mean LIMA flow rate was(22 ± 6) ml/min after anastomosis.Surgery duration was 117-143 minutes,blood loss was less than 100 ml for each operation.No blood transfusion was required.Tracheal intubation time was 4-16 hours,ICU stay time was 22-45 hours,hospital stay time was 6-10 days.There was no peri-operative death,either no myocardial infarction or cerebral vessel accident.During follow-up,all LIMA-LAD appeared to be patent by coronary CT angiography.Conclusion High patency rate of LIMA-LAD anastomosis could also be obtained during MIDCAB surgery.It was reserved as a safe and effective surgery for well-selected patients.