Graft patency and completeness of revascularization in minimally invasive multivessel coronary artery bypass surgery

Abstract

Objectives: Graft patency and completeness of revascularization were analyzed in patients who underwent off-pump minimally invasive coronary artery bypass grafting via left small thoracotomy. Methods: We retrospectively reviewed the invasive angiography findings and clinical data of 186 consecutive patients who underwent off-pump minimally invasive coronary artery bypass grafting via left small thoracotomy. The left internal thoracic artery and saphenous vein were used to bypass two or more of three coronary artery systems: the left anterior descending artery, left circumflex artery, or right coronary artery. Before hospital discharge, invasive angiography was performed to assess graft patency and completeness of revascularization. Clinical variables during hospitalization and follow-up were collected and analyzed. Results: All 186 patients successfully underwent off-pump minimally invasive coronary artery bypass grafting without conversion to sternotomy or assistance of cardiopulmonary bypass. LITA Left internal thoracic artery LCX Left circumflex artery LM Left main artery LVEDD Left ventricular end-diastolic dimension MACCE Major adverse cardiovascular and cerebral events MI Myocardium infarction MICS CABG Minimally invasive coronary surgery-coronary artery bypass grafting OPCAB Off pump coronary artery bypass PCI Percutaneous coronary intervention RA Radial artery RBC Red blood cell RCA Right coronary artery SV Saphenous vein

Commentary: When starting a MICS program, Don't assume excellence: Prove it!

“…We congratulate Zhang and et al 1 on their successful minimally invasive multivessel coronary artery bypass surgery (MICS CABG) program (Figure 1). 1 They present a series of 186 consecutive patients who underwent MICS CABG by expert surgeons at their center. They report excellent graft patency and complete revascularization (CR) rates.…”

“…Zhang et als' 1 series illustrates important principles in the establishment of a MICS program. First, the quality of MICS surgery should be as good as the conventional technique.…”

“…Zhang and et als' 1 approach of ensuring CR and graft patency is well thought out and should be the standard for all surgeons performing MICS CABG, at least for the initial cohort of patients. Long‐term follow‐up will be crucial to demonstrate continued graft patency without increased need for repeat revascularization.…”

When Starting a MICS Program, Don’t Assume Excellence: Prove It!

“…We congratulate Zhang and colleagues on their successful minimally invasive multivessel coronary artery bypass surgery (MICS CABG) program. 1 They present a series of 186 consecutive patients who underwent MICS CABG by expert surgeons at their center. They report excellent graft patency and complete revascularization (CR) rates.…”