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Single coronary artery bypass grafting--a comparison between minimally invasive 'off pump' techniques and
J Bonatti1, R Ladurner, H Antretter
1University Clinic of Surgery/Cardiac Surgery, Innsbruck, Austria. johannes.o.bonatti@uibk.ac.at
Objective:
At present, few studies directly comparing minimally invasive and conventional coronary artery bypass grafting are available. The aim of the present study was to evaluate the clinical outcome of the two techniques.
Methods:
We retrospectively compared our first consecutive 20 patients undergoing minimally invasive coronary artery single bypass grafting on the beating heart (group I) with 23 consecutive patients receiving single coronary artery bypass via sternotomy using cardiopulmonary bypass and cardioplegia (group II). The procedures were performed during the period from Jan 1, 1994 to Feb 20, 1997. There were no significant differences in demographic data.
Results:
Statistically significant differences were found concerning total operative time (172.6 min in group I and 149.6 min in group II P = 0.0009) and myocardial ischemic time (23.7 min local coronary occlusion time in group I and 17.6 min aortic cross-clamp time in group II P = 0.03. Patients treated minimally invasive received significantly fewer blood transfusions (25.0% vs. 69.6% P = 0.0035) and were discharged significantly earlier from the hospital (admission rate on the fifth postoperative day 68.4% in group I vs. 100.0% in group II P = 0.0004).
Conclusion:
We conclude that minimally invasive coronary artery bypass grafting on the beating heart in comparison to conventional single coronary artery bypass grafting during the learning curve requires longer operative times but can reduce blood transfusion requirements and hospital stay.