Early Outcomes Of MIDCAB, A Minimally Invasive Direct Coronary Artery Bypass Surgery

19th International Congress of Update in Cardiology and Cardiovascular Surgery, İstanbul, Türkiye, 4 - 06 Kasım 2023, cilt.11, ss.70

Objective: The minimally invasive direct coronary bypass (MIDCAB) surgery procedures may enhance

healing and shorten hospital stays. To mitigate issues brought on by a complete sternotomy, MIDCAB

surgery was introduced. This study assessed the MIDCAB experience at our clinic, including the

length of the procedure, the number of bypasses, and the conversion to sternotomy.

Methods: We examined a total of 31 consecutive patients with similar demographic properties who

underwent MIDCAB surgery at our institution.

Results: Mortality at 30 days was 0% overall (0/30). Patient's average ages were 60 years old, with

33% of them being women. There was no early myocardial infarction or cardiac-specific mortality.

Postoperative stroke and haemorrhage was not observed in any case. Bilateral carotid

endarterectomy and patch plasty were performed as additional procedures in one patient. Overall 95

distal anastomosis were performed. Mean michanical ventilation duration was 3.8 hours in intenssive

care unit with average mobilization time of 2 hours after extubation. Anastomosis took an average of

15 minutes to complete during the full surgical operation, which took 3 hours on average.

Intraoperative flow were measured after anastomosis in every graft. Endoscopic safenous vein graft

harvesting was used in 73.3% (11/31) of patients. With only one conversion to sternotomy with

cardiac bypass and one use of a safenous vein graft to the left anterior descending artery (LAD) due

to injury to the left internal mammary artery (LMA) during harvesting, in-hospital complication rates

were comparatively modest. The most frequent complication, which was documented in 4 of the

patients, was rib fracture. One patient had thoracotomy insision wound infection requiring revision

while another had an iliac artery dissection caused by femoral artery cannulation that required graft

bypass surgery.

Conclusions: The minimally invasive coronary surgery technique for coronary artery bypass grafting is

a safe and efficient treatment for multivessel revascularization and has developed into a remarkable

substitute for traditional coronary artery bypass grafting. Following surgery, These data show that

minimally invasive coronary bypass surgery has generally satisfactory early results. Future studies

should concentrate on developing comparably powered, randomised trials that are sufficiently

powered to examine major adverse cardiac and cerebrovascular events (MACCE) outcomes over the

short- and long-term.