Early and follow-up angiography in minimally invasive coronary bypass without mechanical stabilization

Background. This study was undertaken to assess the early and late outcome of coronary anastomosis constructed on a beating heart without the help of mechanical stabilization. Methods. All consecutive patients (51) from January 1996 to September 1997 who had bypass done by one surgeon using a left minithoracotomy (39) or med ian sternotomy (12) on a beating heart with occlusive local snares without mechanical stabilization underwent follow-up angiography early (100%) (with in 6 hours) and late (63.5%) at a mean of 9.6 a 4.48 months (range, 3.3 to 19.1 months). Results. The cumulative late patency was 95.4% (83 of 87 patients), with tw o early and two late occlusions. There was no early or late mortality or pe rioperative myocardial infarction. Two patients (3.9%) developed recurrent angina. Four anastomotic irregularities (4 of 32 patients, 12.6%) have clea red up on follow-up angiography. There was no evidence of late stenosis at the snare sites used for local occlusion. Conclusions. Minimally invasive coronary bypass is safe and effective. Earl y angiographic abnormalities should be interpreted with caution and we coul d not demonstrate any long-term deleterious effects of local snaring. (C) 2 000 by The Society of Thoracic Surgeons.