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Can Minimally Invasive Multivessel Coronary Revascularization Be a Routine Approach?
Mugisha Kyaruzi1, Harun Gülmez2, Ergun Demirsoy3
1Department of Cardiovascular Surgery, Liv Hospital, Bahçeşehir, Istinye University, Istanbul, Turkey.
The Thoracic and Cardiovascular Surgeon
|June 1, 2022
Summary
Minimally invasive coronary artery bypass grafting using left anterior minithoracotomy is a safe and effective treatment for multivessel coronary disease. This approach offers good clinical outcomes with a low complication rate.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Coronary Artery Disease Treatment
Background:
- Minimally invasive approaches are advancing cardiovascular surgery for multivessel coronary disease.
- Conventional cardiac surgery poses significant burdens; minimally invasive options aim to improve outcomes.
- This study details a routine technical approach for minimally invasive coronary artery bypass via left anterior minithoracotomy.
Purpose of the Study:
- To describe the technical approach for minimally invasive coronary artery bypass (CABG) via left anterior minithoracotomy.
- To report clinical experience and outcomes in patients with multivessel coronary lesions treated with this technique.
- To evaluate the safety, feasibility, and reproducibility of the procedure.
Main Methods:
- Experience includes 100 consecutive patients operated between July 2020 and April 2021.
- Left internal thoracic artery harvested in all patients; radial and saphenous vein grafts harvested endoscopically.
- Operations performed on cardiopulmonary bypass (CPB) or off-pump via left anterior minithoracotomy (5-7 cm incision).
Main Results:
- Single mortality (1%); no early postoperative myocardial infarction.
- Zero conversion to sternotomy.
- Mean bypasses: 3.1; Mean CPB time: 153.2 min; Mean hospital stay: 4.98 days.
Conclusions:
- Minimally invasive CABG via left anterior minithoracotomy is safe, feasible, and reproducible with a short learning curve.
- The technique can be routinely performed for multivessel coronary lesions.
- Further multicenter studies are recommended for technique standardization.
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