title: Minimally invasive single-vessel coronary artery bypass with the internal thoracic artery and early postoperative angiography: midterm results of a prospective study in 120 consecutive patients.
abstract: BACKGROUND
  This prospective study was undertaken to determine the role of the minimally invasive direct coronary artery bypass with early postoperative angiography and midterm follow-up in 120 consecutive patients with single-vessel coronary artery disease.
  
  
  METHODS
  Minimal access (6 to 10 cm), without complete sternotomy and no cardiopulmonary bypass, was used. The lesions were located at the proximal left anterior descending coronary artery in 95% of the patients. Routine coronary angiography was performed before discharge.
  
  
  RESULTS
  Postoperative angiography was performed in 104 (90.4%) of those 115 patients who had coronary revascularization concluded by the mini-access method. The internal thoracic artery patency rate was 98.1% (95.2% grade A). Two (1.7%) patients presented with perioperative myocardial infarction, which led to the single in-hospital death (0.8%). Of the remaining 119 patients, 113 (95.0%) were asymptomatic. The event-free probability was 94.9% and the actuarial survival was 98.3% with 42 months of follow-up.
  
  
  CONCLUSIONS
  For selected patients with single-vessel coronary artery disease and no major myocardial dysfunction, minimally invasive direct coronary artery bypass is a safe operation and a less invasive alternative to conventional coronary artery bypass grafting.
authors.affiliation: Department of Cardiopneumology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. dcioliveira@incor.usp.br
authors.forename: Sérgio A
authors.initials: SA
authors.lastname: Oliveira
authors.forename: Luiz Augusto F
authors.initials: LA
authors.lastname: Lisboa
authors.forename: Luís Alberto O
authors.initials: LA
authors.lastname: Dallan
authors.forename: Salomon O
authors.initials: SO
authors.lastname: Rojas
authors.forename: Luiz F
authors.initials: LF
authors.lastname: Poli de Figueiredo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000637:transplantation*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D016019:Survival Analysis