[Comparison of sternotomy off-pump coronary artery bypass and minimally invasive technique for isolated single vessel grafting].
OBJECTIVE
To compare the outcomes of minimally invasive coronary artery bypass grafting operation performed via a small thoracotomy versus da Vinci S system (Endo-A-CAB) with sternotomy off-pump coronary artery bypass grafting (OPCAB) for single vessel lesion.


METHODS
From April 2000 to August 2011, a total of 194 patients with single coronary artery stenosis accepted CABG on beating heart were divided into 2 groups by different surgical approaches. Group A (n = 99) received sternotomy OPCAB while Group B (n = 95) underwent Endo-A-CAB. All patients had a history of unstable angina and coronary arteriography showed severe stenosis in left anterior descending artery (LAD). The procedure performed in Group B included robotic internal mammary artery (IMA) harvesting and single manual anastomosis to LAD and/or diagonal branch through small incision thoracotomy. IMA flow was evaluated by the Doppler flow meter after the completion of anastomosis. Grafting patency was evaluated postoperatively by computed tomography angiography (CTA) or angiography.


RESULTS
The ventilation time and postoperative drainage volume in Group B were less than those in Group A ((5.1 ± 2.1) vs (10.1 ± 5.8) h, P = 0.03; (411 ± 295) vs (605 ± 244) ml, P = 0.000). No significant difference existed in blood flow, mortality and postoperative complication morbidity between two groups. All symptoms of angina disappeared.


CONCLUSIONS
As a new advanced modality of revascularization, in comparison with OPCAB, Endo-A-CAB procedure is a less invasive and safer method of coronary artery bypass grafting for single vessel lesion.
Department of Cardiovascular Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.
Yang
Y
Wu
Chang-qing
CQ
Gao
Ming
M
Yang
Cang-song
CS
Xiao
Guo-peng
GP
Liu
D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D012189:Retrospective Studies; D012371:Robotics; D013908:Thoracotomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000601:surgery*