[Total coronary revascularization in elderly and senile patients. Rationale for the surgical approach.]

With increasing life expectancy and the rising prevalence of coronary artery disease among elderly and senile patients, the need to optimize surgical methods of myocardial revascularization is growing. Traditional coronary artery bypass grafting via median sternotomy remains the standard of care for multivessel coronary artery disease; however, in elderly and senile patients, it is often associated with an elevated risk of perioperative complications, including infectious complications, respiratory failure, stroke, cognitive dysfunction, and prolonged recovery time. In this context, minimally invasive myocardial revascularization techniques through a left anterolateral minithoracotomy are attracting increasing interest. This analytical review compares outcomes following minimally invasive coronary artery bypass grafting and sternotomy-based coronary artery bypass grafting with complete myocardial revascularization in elderly and senile patients. The technical features of the approach are discussed, and an analytical review of its efficacy, safety, advantages, and prospects for use in this patient cohort is provided.