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Minimally invasive direct coronary artery bypass: current experience
Hitoshi Hirose1, Atsushi Amano, Akihito Takahashi
1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan. genex@nifty.com
The Heart Surgery Forum
|January 15, 2004
Summary
Minimally invasive direct coronary artery bypass (MIDCAB) offers early recovery with minimal mortality and morbidity. Long-term results show acceptable survival and event-free rates after this cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
Background:
- Minimally invasive direct coronary artery bypass (MIDCAB) is a technique for revascularizing the left anterior descending artery using the left internal mammary artery through a small incision.
- This study evaluates the outcomes of patients who underwent the MIDCAB procedure.
Purpose of the Study:
- To analyze the perioperative and long-term outcomes of patients undergoing Minimally Invasive Direct Coronary Artery Bypass (MIDCAB).
Main Methods:
- A total of 125 patients (96 men, 29 women; mean age 65.1 years) underwent MIDCAB between June 1997 and July 2002.
- Perioperative and follow-up data were collected in a structured database for analysis.
Main Results:
- Coronary anastomosis time averaged 17.0 minutes. Mean intubation, ICU, and hospital stays were 4.0 hours, 1.3 days, and 9.7 days, respectively.
- No hospital deaths or major postoperative complications (heart failure, MI, renal failure, prolonged ventilation, stroke) occurred.
- The 3-year actuarial survival rate was 92.6%, with an event-free rate of 87.1% over a 3.3-year follow-up, though 12 patients experienced angina and 10 died.
Conclusions:
- Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) is a safe procedure associated with early recovery and low mortality/morbidity.
- The long-term outcomes following MIDCAB are considered acceptable, supporting its use in appropriate patients.