Coronary artery bypass grafting via median sternotomy or lateral minithoracotomy

Objectives: In order to evaluate the benefit provided through less invasive surgical techniques for the treatment of multivessel coronary artery disea se, a prospective clinical trial was started. Methods: Group I included 53 patients (38 males, 15 females, age 51-79 years, mean 62.8 +/- 6.1 years) r eceiving conventional bypass surgery, group 2 included 69 patients (59 male , 10 female, age 43-82 years, mean 61.9 +/- 8.6 years) receiving less invas ive surgical procedure including minithoracotomy in combination with cardio pulmonary bypass. Results: No perioperative death occurred in the whole ser ies of patients. Time of operation was 267 +/- 61 min in group 2 and 162.9 +/- 53.6 min in group 1. Intensive Care Unit stay was I day for both groups and Hospitalization 6.9 +/-: 6.0 for group 1 and 7.5 +/- 2.6 days for grou p 2. Perioperative bleeding was less in group 2 (P > 0.01). Back and chest pain assessment on postoperative day 3 showed less pain in group 2 (P < 0.0 5). Three-month follow-up revealed ischemia in stress electrocardiogram in two patients (3.8%) in group 1 and in 2 patients (2.9%) in group 2. Coronar y angiograms confirmed the stress ECG findings. There was one (1.4%) redo o peration in group 2 and two (3.8%) in group 1. Conclusions: Both techniques are equal efficient. Even though time of operation is longer in patients r eceiving less invasive procedure, intensive care unit stay and hospitalizat ion is exactly as long. Patients receiving minimally invasive surgery bleed less and have less pain early postoperatively. (C) 1999 Elsevier Science B .V. All rights reserved.