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Minimally Invasive Isolated and Hybrid Surgical Revascularization for Multivessel Coronary Disease: A Single-Center
Tiziano Torre1, Alberto Pozzoli1, Marco Valgimigli2,3
1Heart Surgery Unit, Cardiocentro Ticino Institute, EOC, 6900 Lugano, Switzerland.
Journal of Personalized Medicine
|May 25, 2024
Summary
Minimally invasive direct coronary artery bypass (MIDCAB) surgery, alone or with hybrid coronary revascularization (HCR), shows excellent long-term results. This approach is safe and effective for selected patients, demonstrating low mortality and re-intervention rates.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Interventional Cardiology
Background:
- Limited long-term data exist for minimally invasive direct coronary artery bypass (MIDCAB) and hybrid coronary revascularization (HCR).
- Previous studies suggest short-term safety and efficacy for these procedures.
Purpose of the Study:
- To evaluate the long-term outcomes of MIDCAB and HCR.
- To assess the safety and effectiveness of these minimally invasive approaches in a selected patient cohort.
Main Methods:
- Retrospective analysis of 1997 coronary artery revascularization patients from February 2013 to December 2023.
- Focused on 92 patients (4.7%) who underwent MIDCAB (isolated or with PCI).
- Median follow-up of 75 months.
Main Results:
- Zero cardiac mortality and 3% overall mortality.
- Low conversion rate to sternotomy (2.1%) and re-exploration rate (4.6%).
- 100% LIMA to LAD grafting; 72% of HCR patients received subsequent PCI.
Conclusions:
- MIDCAB, alone or with HCR, demonstrates favorable short- and long-term outcomes.
- These procedures are safe and effective in carefully selected patients managed by a heart team.
- Encouraging results support the use of MIDCAB and HCR for appropriate candidates.
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