Minimally invasive direct coronary artery bypass grafting: Intermediate-term results

Background. Intermediate- and long-term clinical outcome and graft patency in minimally invasive direct coronary artery bypass grafting (MIDCABG) proc edures remain a concern. Methods. Over a 13-month period, 66 MIDCABG procedures were performed utili zing robotic-assisted internal mammary artery (IMA) harvesting and direct C ABG through a 5-cm thoracotomy without cardiopulmonary bypass. Clinical fol low-up was obtained on all patients. Graft patency was assessed in 61 of 66 consecutive patients 6 months (range 2 to 15 months) postoperatively. Grou p I consisted of 45 patients who underwent IMA angiography and group II con sisted of 16 patients who underwent both a nuclear stress test and transtho racic Doppler examination. All group II patients had abnormal preoperative nuclear stress tests for comparison. Results. To date, all 66 patients are alive. Graft patency rates in the two groups were 97.8% (45 of 46 grafts in 45 patients) in group I and 100% (15 of 15 grafts), with one indeterminate study, in group II. The overall pate ncy rate for the entire study group was 98.3% (60 of 61 grafts). Sixty-two of 66 (93.9%) patients were able to return to their normal level of activit y within 3 weeks. Conclusions. This study demonstrates that the MIDCABG with thoracoscopic IM A harvesting can achieve effective intermediate-term revascularization and an acceptable clinical outcome. (Ann Thorac Surg 2000;70:1063-5) (C) 2000 b y The Society of Thoracic Surgeons.