Minimally invasive direct coronary artery bypass versus off-pump coronary surgery through sternotomy

Abstract

MIDCAB can be performed safely in appropriately selected patients with outcomes comparable with OPCAB. The potential benefits include shorter hospital stay, reduced need for blood transfusion and faster recovery.

Minimally invasive single‐vessel left internal mammary to left anterior descending artery bypass grafting improves outcomes over conventional sternotomy: A single‐institution retrospective cohort study

“…Ruel et al demonstrated in 91 patients no operative mortality or MACE in patients receiving an average of three bypass grafts via a minimally‐invasive approach. Birla et al in their retrospective review of 74 MICABG and 78 OPCAB patients undergoing LIMA‐LAD bypasses reported equivalent mortality and postoperative morbidity supporting the safety of this alternative operative approach.…”

“…Compared with these previous reports, our volume is considerably smaller, yet we demonstrate a significant a short‐term thirty‐day mortality and a long‐term 5‐year survival benefit among all‐comers with comparable perioperative MACE and improved 5‐year MACE‐free survival compared with a conventional sternotomy approach. This has been echoed in other experiences of similar volume . Ruel et al demonstrated in 91 patients no operative mortality or MACE in patients receiving an average of three bypass grafts via a minimally‐invasive approach.…”

“…5,6 Experience with MICABG has demonstrated reductions in LOS (LOS) and perioperative transfusion requirements with comparable rates of major adverse cardiac events (MACE) and shorter recovery time compared with conventional off-pump CABG (OPCAB) utilizing a sternotomy. [7][8][9] Although operative time is significantly increased for MICABG, low rates of conversion to sternotomy, need for cardiopulmonary bypass (CPB), and other intraoperative complications have been reported. 9,10 Early postoperative mortality of 0.8% with 6-month graft patency at 92%-100% has attested to the safety and durability of minimally-invasive approaches.…”

Current state and future direction of hybrid coronary revascularization

“…Second, the use of drug-eluting stents appears to be inferior to the excellent long-term patency seen when the LIMA is grafted to the LAD coronary artery (LIMA-LAD), as suggested by the long-term outcomes of a randomized clinical trial [7] as well as data from a recent metaanalysis, which show lower rates of target vessel revascularization with an odds ratio (OR) of 0.16, 95% confidence interval (CI): 018-0.30, P < 0.001 [8]. Third, the use of an isolated LIMA-LAD graft allows the use of off-pump, minimally invasive surgical techniques, which may lower complication rates and shorten postprocedural recovery compared with conventional surgical techniques [9][10][11][12].…”

Assessment of Physical Activity by Wearable Technology During Rehabilitation After Cardiac Surgery: Explorative Prospective Monocentric Observational Cohort Study (Preprint)

“…This is in contrast to other studies [28][29][30], which could be due to small sample size. But this variable might be dependent on institutional protocols and decision-making of physicians and surgeons as well [31].…”