title: Surgical pitfalls of minimally invasive direct coronary artery bypass procedure from the viewpoint of a surgeon in the learning curve.
abstract: BACKGROUND
  Minimally invasive direct coronary artery bypass grafting (MIDCAB) offers arterial revascularization of the left anterior descending (LAD) coronary artery especially in lesions unsuitable for percutaneous coronary interventions. By avoidance of sternotomy and cardiopulmonary bypass its invasiveness is less than that of conventional bypass surgery.
  
  
  OBJECTIVE
  We in this study discuss our surgical experience in the MIDCAB procedure.
  
  
  METHODS
  Thirteen patients were operated on with the MIDCAB procedure. The inclusion criteria for MIDCAB were pure LAD disease totally occluded or severely stenotic. Patient demographics and preoperative and postoperative data were analyzed.
  
  
  RESULTS
  Mean age of the patients was 60.0 ±8.6 years. Patients' preoperative and postoperative levels of cardiac CK-MB (creatine kinase MB) were not significantly different (p = 0.993). However, cardiac troponin I (p < 0.001), hemoglobin (p < 0.001) and hematocrit (p < 0.001) were significantly different. No perioperative myocardial infarctions or cerebrovascular accidents were seen. The patients were discharged at a mean day of 4.77 with oral antiaggregant therapy. No mortality was seen in the study population.
  
  
  CONCLUSIONS
  Minimally invasive direct coronary artery bypass is associated with few perioperative complications. Minimally invasive direct coronary artery bypass in our experience is a very good option for single vessel LAD disease.
authors: Department of Cardiovascular Surgery, Pamukkale University, Denizli, Turkey.
authors: Bilgin
authors: B
authors: Emrecan
authors: Ahmet Coşkun
authors: AC
authors: Ozdemir
keywords: coronary artery disease; minimally invasive cardiac surgery
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