Minimally invasive coronary artery bypass grafting versus off-pump: a propensity-matched study for patients with multi-vessel lesion
10.3760/cma.j.cn112434-20200903-00406
- VernacularTitle:肋间单一切口直视微创多支OPCABG临床效果：倾向性评分匹配研究
- Author:
Jiaji LIU
1
;
Qingyu KONG
;
Liqun CHI
;
Wei XIAO
;
Lin LIANG
;
Yu HUANG
;
Feng PAN
Author Information
1. 北京市心肺血管疾病研究所 首都医科大学附属北京安贞医院心脏外科，北京 100029
- Keywords:
Minimal invasive;
Propensity Score-matching;
Multivessel off-pump coronary artery bypass grafting
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(3):184-189
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the perioperative outcomes and short-term graft patency between patients who underwent multivessel off-pump coronary artery bypass graft(OPCABG) via left intercoastal space or sternotomy.Methods:Between January 2017 and August 2019, 100 patients who underwent minimal invasive coronary artery bypass graft(MICS CABG) were compared with 235 patients who underwent OPCABG by single surgeon at our institute. Among them, 257 cases were male and 78 were female, aged 34 to 84 years, with mean age(61.35±8.79)years old. Due to important differences in patients’ characteristics, a propensity score-matched analysis based on 12 covariates was performed to match in a 1∶2 fashion. 82 patients(MICS group) were matched with 127 patients(OPCABG group). Surgical and postoperative outcomes were evaluated.Results:There was no statistical difference of perioperative mortality, myocardial infarction, and stroke rate( P>0.05). In MICS group, use of internal thoracic artery was higher and conversion to cardiopulmonary bypass was lower( P<0.05), but reoperation, new onset atrial fibrillation , and the use of mechanical device were similar( P>0.05). In addition, operation duration was longer but transfusion rate, postoperative chest tube drainage within 24 hours and postoperative hospital stays were less in the MICS group( P<0.05). LIMA, vein and overall graft patency were similar in the two groups shown by postoperative one-year CTA( P>0.05). Conclusion:MICS CABG is safe and feasible for patients with multiple coronary lesions. It has similar in-hospital outcomes and short-term graft patency but less transfusion and faster recovery compared to conventional OPCABG via sternotomy.
