Perioperative results of minimally invasive direct coronary artery bypass grafting for left anterior descending artery revascularization_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Zhen , LIU Jian , ZENG Qingshi , XIE Bin ,  GUO Huiming

Department of Cardiac Surgery, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medical Sciences, Guangdong Provincial Institute of Cardiovascular Diseases, Guangzhou, 510000, P.R.China;

Corresponding author：

GUO Huiming, Email: guohuiming@vip.tom.com

Keywords：

Coronary artery bypass grafting; minimally invasive small incision; anterior descending artery; coronary artery disease; surgery

DOI：

10.7507/1007-4848.202008071

Video：

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Objective To investigate the perioperative results and safety of minimally invasive direct coronary artery bypass grafting (MIDCAB) treatment of anterior descending artery disease through a small left thoracic incision assisted by thoracoscopy. Methods The clinical data of 92 patients who received MIDCAB in our hospital from May 2014 to October 2018 were retrospectively analyzed, including 72 (78.26%) males aged 42-78 (61.2±7.48) years, and 20 (21.74%) females aged 30-80 (61.30±12.26) years. The perioperative complications, blood product use, left heart function changes, ventilator use time, ICU stay, hospital stay and other indicators were analyzed. Results Two (2.17%) patients were transferred to thoracotomy, 5 (5.43%) patients received blood products during the operation, 2 (2.17%) were subjected to secondary thoracotomy to stop bleeding, 4 (4.34%) had postoperative hypoxemia and 1 (1.08%) was reintubated. The ventilator use time was 3-227 (22.35±35.39) hours, the ICU stay was 16-777 (78.85±108.62) hours, and the postoperative hospital stay was 2-36 (8.86±6.05) days. One (1.08%) patient died in hospital. Conclusion MIDCAB for anterior descending artery disease has good perioperative results, especially for solitary anterior descending artery disease, which can reduce the use of blood products, and shorten the time of ventilator use after operation, ICU stay and hospital stay.

Citation： ZHANG Zhen, LIU Jian, ZENG Qingshi, XIE Bin, GUO Huiming. Perioperative results of minimally invasive direct coronary artery bypass grafting for left anterior descending artery revascularization. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(2): 198-201. doi: 10.7507/1007-4848.202008071 Copy

1.	Benetti F, Mariani MA, Sani G, et al. Video-assisted minimally invasive coronary operations without cardiopulmonary bypass: a multicenter study. J Thorac Cardiovasc Surg, 1996, 112(6): 1478-1484.
2.	Tekin Aİ, Arslan Ü. Perioperative outcomes in minimally invasive direct coronary artery bypass versus off-pump coronary artery bypass with sternotomy. Wideochir Inne Tech Maloinwazyjne, 2017, 12(3): 285-290.
3.	Reser D, Hemelrijck Mv, Pavicevic J, et al. Mid-term outcomes of minimally invasive direct coronary artery bypass grafting. Thorac Cardiovasc Surg, 2015, 63(4): 313-318.
4.	Raja SG, Garg S, Rochon M, et al. Short-term clinical outcomes and long-term survival of minimally invasive direct coronary artery bypass grafting. Ann Cardiothorac Surg, 2018, 7(5): 621-627.
5.	Gorki H, Patel NC, Balacumaraswami L, et al. Long-term survival after minimal invasive direct coronary artery bypass (MIDCAB) surgery in patients with low ejection fraction. Innovations (Phila), 2010, 5(6): 400-406.
6.	Hoffmann G, Friedrich C, Barrabas M, et al. Short- and long-term follow-up after minimally invasive direct coronary artery bypass in octogenarians. Interact Cardiovasc Thorac Surg, 2016, 23(3): 377-382.
7.	Kofidis T, Emmert MY, Paeschke HG, et al. Long-term follow-up after minimal invasive direct coronary artery bypass grafting procedure: a multi-factorial retrospective analysis at 1000 patient-years. Interact Cardiovasc Thorac Surg, 2009, 9(6): 990-994.
8.	Ruel M, Shariff MA, Lapierre H, et al. Results of the minimally invasive coronary artery bypass grafting angiographic patency study. J Thorac Cardiovasc Surg, 2014, 147(1): 203-208.
9.	Seo DH, Kim JS, Park KH, et al. Mid-term results of minimally invasive direct coronary artery bypass grafting. Korean J Thorac Cardiovasc Surg, 2018, 51(1): 8-14.
10.	Repossini A, Di Bacco L, Nicoli F, et al. Minimally invasive coronary artery bypass: Twenty-year experience. J Thorac Cardiovasc Surg, 2019, 158(1): 127-138.

1. Benetti F, Mariani MA, Sani G, et al. Video-assisted minimally invasive coronary operations without cardiopulmonary bypass: a multicenter study. J Thorac Cardiovasc Surg, 1996, 112(6): 1478-1484.
2. Tekin Aİ, Arslan Ü. Perioperative outcomes in minimally invasive direct coronary artery bypass versus off-pump coronary artery bypass with sternotomy. Wideochir Inne Tech Maloinwazyjne, 2017, 12(3): 285-290.
3. Reser D, Hemelrijck Mv, Pavicevic J, et al. Mid-term outcomes of minimally invasive direct coronary artery bypass grafting. Thorac Cardiovasc Surg, 2015, 63(4): 313-318.
4. Raja SG, Garg S, Rochon M, et al. Short-term clinical outcomes and long-term survival of minimally invasive direct coronary artery bypass grafting. Ann Cardiothorac Surg, 2018, 7(5): 621-627.
5. Gorki H, Patel NC, Balacumaraswami L, et al. Long-term survival after minimal invasive direct coronary artery bypass (MIDCAB) surgery in patients with low ejection fraction. Innovations (Phila), 2010, 5(6): 400-406.
6. Hoffmann G, Friedrich C, Barrabas M, et al. Short- and long-term follow-up after minimally invasive direct coronary artery bypass in octogenarians. Interact Cardiovasc Thorac Surg, 2016, 23(3): 377-382.
7. Kofidis T, Emmert MY, Paeschke HG, et al. Long-term follow-up after minimal invasive direct coronary artery bypass grafting procedure: a multi-factorial retrospective analysis at 1000 patient-years. Interact Cardiovasc Thorac Surg, 2009, 9(6): 990-994.
8. Ruel M, Shariff MA, Lapierre H, et al. Results of the minimally invasive coronary artery bypass grafting angiographic patency study. J Thorac Cardiovasc Surg, 2014, 147(1): 203-208.
9. Seo DH, Kim JS, Park KH, et al. Mid-term results of minimally invasive direct coronary artery bypass grafting. Korean J Thorac Cardiovasc Surg, 2018, 51(1): 8-14.
10. Repossini A, Di Bacco L, Nicoli F, et al. Minimally invasive coronary artery bypass: Twenty-year experience. J Thorac Cardiovasc Surg, 2019, 158(1): 127-138.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Perioperative results of minimally invasive direct coronary artery bypass grafting for left anterior descending artery revascularization

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