Abstract 18959: Minimally Invasive CABG: Results to 6 years
OBJECTIVE: To evaluate the longitudinal outcomes of minimally invasive CABG (MICS CABG).
METHODS: We prospectively followed 800 consecutive patients who underwent MICS CABG, performed through a 4-6 cm thoracotomy in the left 5th intercostal space. During MICS CABG, the left internal thoracic artery was harvested under direct vision with long instruments, proximal anastomoses were handsewn onto the ascending aorta after mobilizing it in a stepwise fashion, and all myocardial territories were accessed for distal anastomoses by using an apical positioner and/or epicardial stabilizer. All operations were performed by either one of two surgeons. Mean follow-up was 2.2 years (maximum 6.4 years).
RESULTS: Mean patient age was 63.5 ± 10.8 years and 197 patients were female (24.6%). A mean of 2.2 ± 0.8 grafts were performed. Peripheral cardiopulmonary bypass assistance was used in 77 patients (9.6%). There were 25 (3.1%) conversions to sternotomy, and 26 (2.7%) reoperations for bleeding. New onset atrial fibrillation occurred in 187 (23.4%). Overall, the median hospital length of stay was 4 days, and perioperative mortality was 1.0% (8/800). No deep wound infection occurred. At 2 years postoperatively, mid-term survival after MICS CABG was 98.0 ± 0.7%, and 22 patients (2.8%) had undergone percutaneous coronary reintervention.
CONCLUSIONS: These results indicate that MICS CABG constitutes a feasible and increasingly established minimally invasive alternative for patients in need of multivessel CABG. It is associated with a short hospital length of stay, no deep wound infections, and is a safe, reproducible operation yielding survival and durability results in par with that of conventional CABG.
- © 2012 by American Heart Association, Inc.