Coronary artery bypass grafting via median sternotomy or lateral minithoracotomy.
OBJECTIVE
In order to evaluate the benefit provided through less invasive surgical techniques for the treatment of multivessel coronary artery disease, a prospective clinical trial was started.


METHODS
Group 1 included 53 patients (38 males, 15 females, age 51-79 years, mean 62.8 +/- 6.1 years) receiving conventional bypass surgery, group 2 included 69 patients (59 male, 10 female, age 43-82 years, mean 61.9 +/- 8.6 years) receiving less invasive surgical procedure including minithoracotomy in combination with cardiopulmonary bypass.


RESULTS
No perioperative death occurred in the whole series of patients. Time of operation was 267 +/- 61 min in group 2 and 162.9 +/- 53.6 min in group 1. Intensive Care Unit stay was 1 day for both groups and Hospitalization 6.9 +/- 6.0 for group 1 and 7.5 +/- 2.6 days for group 2. Perioperative bleeding was less in group 2 (P > 0.01). Back and chest pain assessment on postoperative day 3 showed less pain in group 2 (P < 0.05). Three-month follow-up revealed ischemia in stress electrocardiogram in two patients (3.8%) in group 1 and in 2 patients (2.9%) in group 2. Coronary angiograms confirmed the stress ECG findings. There was one (1.4%) redo operation in group 2 and two (3.8%) in group 1.


CONCLUSIONS
Both techniques are equal efficient. Even though time of operation is longer in patients receiving less invasive procedure, intensive care unit stay and hospitalization is exactly as long. Patients receiving minimally invasive surgery bleed less and have less pain early postoperatively.
Gulielmos
V
V
Cardiovascular Institute, University Dresden, Germany.
Brandt
M
M
Dill
H M
HM
Knaut
M
M
Cichon
R
R
Matschke
K
K
Schueler
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis / Q000601:surgery*; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome