Angiographic evaluation of graft patency in minimally invasive direct coronary artery bypass grafting

Background. The objective of this report is to describe our experience usin g minimally invasive direct coronary artery bypass grafting and to evaluate angiographic patency of anastomoses. Methods. A total of 120 patients (86 men) were operated on, with ages rangi ng from 30 to 83 years (mean = 61.2 years). Two access routes were used: fo r single left anterior descending coronary artery lesions an 8 cm anterior minithoracotomy was performed at the fourth left intercostal space. Extraco rporeal circulation was not used. In the Last 82 patients a restraining dev ice was used for the regional reduction of heart beats. Coronary cineangiog raphy was carried out between postoperative days 1 and 3 in 84 (70%) patien ts. Anastomoses were graded: grade A, no blocks; grade B, blocks of more th an 50%; grade C, occlusion. This evaluation was performed for two different periods: in the first period a restraining device was not used and in the second period a restraining device was used. Results. In the first study period (38 anastomoses) coronary cineangiograph y showed grade A, 79%, grade B, 5.2%, and grade C, 15.8%. Ln the second stu dy period (62 anastomoses), angiography showed grade A, 90.4%, grade B, 6.4 %, and grade C, 3.2%. Early mortality was 1.6%. Conclusions. Minimally invasive coronary artery bypass grafting is a good a lternative for some groups of patients. Anastomotic results seem to be bett er when a restraining device is used. (Ann Thorac Surg 2000;70:1066-9) (C) 2000 by The Society of Thoracic Surgeons.