[Minithoracotomy myocardial revascularization: results of early angiographic control]

Minimally invasive direct coronary artery by-pass (MIDCAB) has been proposed as an alternative technical solution in different clinical settings. However, a systematic angiographic study of the results obtained using this new technique has not been published yet. This paper summarizes our preliminary angiographic results with MIDCAB.

From January 1995 to January 1997, 56 patients underwent MIDCAB. All patients were followed up regularly and underwent stress myocardial scintigraphy. A postoperative angiographic control was performed in 48 patients (87.2% of the total) at a mean postoperative interval of 1.7 +/- 2 months.

One patient died in hospital. Five patients required further surgery using conventional techniques (either surgical or percutaneous). In 41/48 patients (85.4%), the mammary artery graft and the left anterior descending artery (LAD) were normal. In two cases, we found an anastomotic stenosis, in two cases there was a LAD lesion distal to the anastomosis (at the application site of the stay sutures), one case showed an anastomotic stenosis associated with a distal LAD stenosis, one case had a mammary graft occlusion and one case showed a thrombus-like image in the LAD proximal to the anastomosis.

Systematic angiographic follow-up of MIDCAB patients seems mandatory in order to evaluate the effectiveness of the technical solutions utilized and to optimize various aspects of this new procedure.