Minimally invasive coronary bypass grafting for treating multivessel coronary disease: A single-center prospective...

The study sought to explore the characteristics and outcomes of patients undergoing clinically indicated minimally invasive cardiac surgery-coronary artery bypass grafting (MICS-CABG) and off-pump coronary artery bypass for MICS-CABG eligible multivessel disease, to inform the design of a confirmatory comparative effectiveness trial.

Over 30 months, 245 MICS-CABG and 158 off-pump coronary artery bypass participants were enrolled. Health-related quality-of-life was assessed using the 36-Item Short-Form Health Survey and Seattle Angina Questionnaire. The primary end point was the score on the physical component summary and mental component summary subscale of the 36-Item Short-Form Health Survey (on which scores range from 0 to 100, with higher scores indicating better health status).

The score on the Physical Component Summary-United States subscale of the 36-Item Short-Form Health Survey increased to a greater extent with MICS-CABG than with off-pump coronary artery bypass at both 7 and 30 days (P = .002 and P = .001, respectively), as well as Physical Component Summary-Hong Kong subscale (MICS-CABG and off-pump coronary artery bypass: P = .002 and P < .001, respectively). The mental component summary subscale of the 36-Item Short-Form Health Survey in either the United States or Hong Kong and all 5 domains of Seattle Angina Questionnaire score were similar between the 2 groups throughout the follow-up period.

MICS-CABG, an emerging modality for treating multivessel coronary disease, yields an improved 7- and 30-day physical function than off-pump coronary artery bypass. Moreover, both strategies resulted in similar significant relief from angina over 12 months. A randomized controlled trial is warranted to compare the efficacy of these 2 revascularization strategies. (Prospective Cohort Study on Minimal Invasive Coronary Surgery: NCT04267835).