One-year clinical outcome after minimally invasive direct coronary artery bypass.
BACKGROUND
Minimally invasive coronary artery bypass (MIDCAB) is a new surgical technique by which the left internal mammary artery is anastomosed under direct visualization to the left anterior descending artery without cardiopulmonary bypass.


RESULTS
We followed all 274 patients who underwent MIDCAB from the time it was introduced at a single center. In-hospital and 1-year clinical events were source-documented and adjudicated. The in-hospital major acute cardiac event rate was 2.2%; this included a 1.1% mortality rate. At 1 year, the respective rates were 7.8% and 2. 5%. When compared with the initial 100 procedures, the subsequent 174 procedures had shorter vessel occlusion times (10+/-5 versus 14+/-6 minutes; P:=0.009), times to extubation (6+/-3 versus 14+/-10 hours; P:<0.001), and lengths of hospital stay (2.1+/-1.9 versus 3. 2+/-3.1 days; P:=0.04). Cumulative 1-year adverse cardiac events were 11% in the initial 100 cases and 6% in the subsequent 174 cases (P:=0.17).


CONCLUSIONS
Excellent clinical results can be achieved with the MIDCAB technique. The clinical adverse event rate may decrease with accumulated experience.
Mehran
R
R
Cardiovascular Research Foundation, New York, NY 10022, USA. rmehran@crf.org
Dangas
G
G
Stamou
S C
SC
Pfister
A J
AJ
Dullum
M K
MK
Leon
M B
MB
Corso
P J
PJ
D002315:Cardiopulmonary Bypass / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control; D016896:Treatment Outcome