SYSTEMATIC CLINICAL AND ANGIOGRAPHIC FOLLOW-UP OF PATIENTS UNDERGOINGMINIMALLY INVASIVE CORONARY-ARTERY BYPASS

Objective: We herein analyze the results of the systematic clinical an d angiographic control performed in a series of 77 consecutive patient s undergoing minimally invasive coronary artery bypass. Methods end Re sults: From January 1995 to June 1997, 77 patients underwent minimally invasive coronary artery bypass at our institution. There was one inh ospital death, one noncardiac late death, and five patients had to be reoperated for graft malfunction, A total of 76 patients underwent pos toperative angiographic follow-up. In 66 cases (86.8%) the thoracic ar tery graft, the target vessel, and the anastomosis were patent and fun ctioning normally. In one case the graft was occluded, In the remainin g nine cases the thoracic artery graft was patent but with major anoma lies of either the anastomosis, the target vessel, or the course of th e thoracic artery. Patients operated using especially designed instrum ents had angiographic results clearly superior to those of patients op erated using conventional instrumentation (perfect patency rate 100% v s 81.8%), At a mean follow-up of 18 months, 98.5% of the surviving pat ients are asymptomatic with negative myocardial scintigraphy, Conclusi ons: The perfect patency rate of minimally invasive revascularization performed without the use of dedicated instruments is unacceptably low . The use of specific devices is likely to result in a substantial imp rovement in the angiographic results.