Port-access coronary artery bypass grafting: Technique and comparative results

Background. Interest in minimally invasive coronary artery bypass grafting (CABG) continues to grow, and the techniques evolve. Our study examines the technical strategies of port-access (PA) CABG and compares results between PA CABG and conventional CABG. Methods. Two hundred and twenty-nine consecutive patients underwent PA CABG from December 1996 through July 1998. Postoperative complications were com pared with a matched cohort of conventional access patients. Operative tech nique and times were reviewed in the PA group. Results. The average Society of Thoracic Surgeons (STS) risk assessment was 1.3 in both groups. Observed mortality was 0.90%. Complications of stroke, perioperative myocardial infarction, and atrial fibrillation were not sign ificantly different between the two groups. Reoperation for bleeding was mo re likely in the PA group, while infections were more likely in the sternot omy group (p < 0.05). Transfusion requirements and postoperative length of stay were lower in the PA group (p < 0.05). Conclusions. Early results were similar between these two low-risk cohort g roups. These findings support continued careful use of port-access revascul arization in low-risk patients. Close follow-up of outcomes is essential to define the appropriateness of port-access techniques in patients requiring surgical revascularization. (C) 1999 by The Society of Thoracic Surgeons.