Minimally invasive coronary artery bypass: Twenty-year experience

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Coronary Artery Disease Management

Background:

• Minimally invasive direct coronary artery bypass (MIDCAB) is a surgical technique for coronary artery revascularization.
• The left thoracic artery is a common graft used in MIDCAB procedures, particularly for the left anterior descending artery.

Purpose of the Study:

• To evaluate the long-term outcomes of minimally invasive direct coronary artery bypass (MIDCAB) for the left anterior descending artery.
• To assess the safety, efficacy, and durability of MIDCAB in a large patient cohort.

Main Methods:

• Retrospective analysis of 1060 patients undergoing MIDCAB between 1997 and 2016.
• Evaluation of outcomes including major adverse cardiac and cerebral events, freedom from angina, and graft patency.
• Long-term follow-up data analyzed using Kaplan-Meier survival curves.

Main Results:

• High graft patency rate of 96.8% within 10 years.
• Excellent long-term survival: 79.8% at 15 years.
• Low rates of postoperative death (0.8%) and stroke (0.3%), with 70.5% freedom from major adverse events at 15 years.

Conclusions:

• Minimally invasive direct coronary artery bypass is a safe and effective surgical option.
• The procedure is associated with low morbidity and mortality, excellent long-term survival, and reduced invasiveness.
• MIDCAB provides durable results with high graft patency and significant freedom from adverse events.