[Clinical experiences of minimally invasive direct coronary artery bypass (MIDCAB)]

From Jan. to Oct. in 1997, we performed 18 minimally invasive direct coronary artery bypass (MIDCAB), aged from 45 to 86 years (the mean age of 69 years). They had single LAD disease post PTCA failure in 2 patients, and multiple vessel disease in 16 patients including left main stenosis in 2 patients. Sixteen patients had associated risk factors for using cardiopulmonary bypass, such as cerebrovascular disease in 9 patients, calcification of ascending aorta in 5 patients, renal failure in 2 patients, old age over 80 years in 4 patients and cancer in one patient. Single bypass grafting of left internal thoracic artery (LITA) to left anterior descending artery (LAD) underwent through left anterior small thoracotomy in 9 patients, double bypass grafting of gastroepiploic artery or right ITA to right coronary artery with LITA to LAD in 9 patients through subxiphoid small incision or right anterior small thoracotomy. The mean number of distal anastomosis was 1.5/patient. All patients are alive and asymptomatic, and postoperative angiography demonstrated the patency rate of 96.2% (26/27). MIDCAB is considered as a justified and safe technique for the patients who are ineligible for standard coronary artery bypass grafting.