Surgical Results of Minimally Invasive Coronary Artery Bypass Grafting

Introduction: We report our clinical results of off-pump minimally invasive coronary artery bypass grafting( MICS CABG) under direct vision as our initial experience. Surgery: An 8-10 cm incision was made in the left 4-5th intercostal space (ICS). Bilateral internal thoracic artery (BITA) were harvested under direct vision with the use of 32 cm Harmonic scalpel through the surgical port. And the right lung is displaced by a tissue stabilizer via subxiphoid incision. Subsequently, proximal anastomosis was made onto the ascending aorta with a tissue stabilizer to displace the pulmonary artery. After preparing for all grafts, distal anastomosis were done using tissue stabilizer with direct retraction technique.

Results: Between February 2014 and June 2015, 50 cases of MICS CABG were done in our hospital. A total of 19 cases were done using BITA. The average number of distal anastomoses was 2.6±1.2. The average operative time was 301.4±96.9 min. There was no mortality and no conversion to sternotomy, however there was an on-pump conversion.

Conclusions: Off pump multi-vessel MICS CABG and harvesting BITA via left small thoracotomy under direct vision are feasible. Using BITA may provide advantages of long term benefits as a standard CABG and a hybrid coronary revascularization in MICS CABG.