Left Anterior Mini-Thoracotomy vs. Conventional Sternotomy in On-Pump Multivessel Coronary Revascularization

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Conventional sternotomy for coronary artery bypass grafting (CABG) is associated with significant morbidity.
• Minimally invasive techniques aim to reduce surgical trauma and improve patient outcomes.

Purpose of the Study:

• To compare the outcomes of on-pump multivessel coronary revascularization using left anterior mini-thoracotomy versus conventional sternotomy.

Main Methods:

• A retrospective analysis of 262 patients undergoing on-pump multivessel CABG.
• Group I: 132 patients (minimally invasive left anterior mini-thoracotomy).
• Group II: 130 patients (conventional full sternotomy).
• Comparison of intraoperative, postoperative, and mortality parameters.

Main Results:

• Minimally invasive group (Group I) had significantly longer cardiopulmonary bypass (152.24 ± 36.4 min) and cross-clamping times (86 ± 13.2 min) (P<0.001).
• Group I demonstrated significantly shorter intensive care (P=0.005) and hospital stays (P=0.004).
• Perioperative mortality was similar between groups (1 patient each), with comparable bleeding requiring revision.

Conclusions:

• Left anterior mini-thoracotomy is an effective and reliable method for multivessel CABG.
• Benefits include reduced drainage, less need for blood transfusion, shorter hospitalizations, and improved cosmetic results.
• This approach facilitates a faster return to daily life compared to conventional sternotomy.