Application of axillary-coronary artery bypass in minimally invasive cardiac surgery-coronary artery bypass graft
10.3760/cma.j.cn112434-20240202-00034
- VernacularTitle:左腋动脉近端吻合在左胸小切口多支旁路移植手术中的应用
- Author:
Luyu MENG
1
;
Yunpeng LING
;
Yuanhao FU
;
Yichen GONG
Author Information
1. 北京大学第三医院心脏外科，北京 100191
- Keywords:
Coronary artery bypass graft;
Minimally invasive cardiac surgery;
Quality of life;
Major adverse cardiovascular and cerebrovascular events;
Graft patency
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(9):542-548
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and effectiveness of axillary-coronary artery bypass (ACAB) of anterolateral incision multi-vessel coronary artery bypass surgery (MICS-CABG).Methods:Patients who underwent coronary artery bypass surgery in Peking University Third Hospital from May 2020 to December 2022 were included. 48 and 158 patients were included in MICS-ACAB and OPCABG group respectively. The mean age of the OPCABG group was (64.72±8.27) years old, and the male proportion was 77.2%(122 cases). The mean age of the MICS-ACAB group was (71.42±7.77) years old, and the male proportion was 79.2%(38 cases). Major adverse cardiovascular and cerebrovascular events (MACCE, including stroke, death, myocardial infarction and revascularization) and postoperative PCS scores of SF-36 were selected as the primary endpoint. The surgical complications and angiography patency rate of grafts were recorded to evaluate the clinical effects of MICS-ACAB.Results:The median number of bypass graft in two groups was 3. There were no significant differences in perioperative MACCE, re-operation rate, renal failure and lenth of postoperative hospital stay between two groups( P>0.05). 85.4% of patients reveived angiography assessment before discharge. There was no significant difference in graft patency between the MICS-ACAB group and OPCABG group (95.2% vs 88.8%, P=0.368). The results of propensity score matching analysis were consistent with the above conclusions. Both univariate analysis and multiple linear regression showed that MICS-ACAB could improve the PCS score of SF-36 at 7 days after surgery[(31.77±5.97) scores vs. (29.45±6.31) scores, P=0.025]. Conclusion:The safety of MICS-ACAB is satisfactory, which can achieve the completely revascularization and the patency rate of grafts is desirable. This procedure can significantly improve quality of life of patients in early postoperative period.
