Which place for Port Access surgery in coronary artery bypass grafting? A mid-term follow up study.
Between May 1997 and November 2002, 68 patients with one or two-vessel disease (55+/-9 years) underwent Port Access CABG using the Heartport endoCPB. The LITA was used in 63 cases, the RITA in 14, a radial artery in 2 and a vein graft in 3. Mean distal anastomoses was 1.3+/-0.5. Cross clamping, CPB, and operative times were 42+/-20 min, 64+/-27 min, and 3.8+/-1.5 h. Postoperative ventilation was 11+/-17 h, and ICU stay was 1.9+/-2.6 days. At day-1, troponin level was 2.3+/-2.9 UI and blood loss was 398+/-240 ml. Two patients needed long intubation and two had pleural re-drainage. One patient had a stroke, one had a myocardial infarction, and one underwent revision for bleeding. Hospital stay was 7+/-3 days. 65% were discharged to home. Follow up was completed in all cases (4.1+/-1.8 years). CCS score was significantly reduced (from 3.1+/-0.3 to 1.1+/-0.3, P<0.0001). Two patients had PTCA and stenting of non-grafted arteries. Five other patients had recurrent angina. Angiograms showed patent grafts in all cases. Two patients died after 19 months and 5 years from non cardiac reasons. In conclusion, Port Access CABG remains a safe technique with stable results at mid-term follow up.
Department of Cardiovascular Surgery (Pr Jegaden), Hôpital Pradel, Université Claude Bernard, INSERM E0226, 28, avenue du doyen Lepine, 69677 Bron Cedex, France. fadi.farhat@chu-lyon.fr
Fadi
F
Farhat
Mathieu
M
Vergnat
Pascale
P
Blanc
Pascal
P
Chiari
Olivier
O
Jegaden