Clinical efficacy of minimally invasive coronary artery bypass grafting via left intercostal small incision for multivessel coronary artery disease: A retrospective cohort study
- VernacularTitle:左侧肋间小切口微创冠状动脉旁路移植术治疗多支冠状动脉病变的回顾性队列研究
- Author:
Zeyuan ZHAO
1
;
Zhihua WANG
1
;
Sheng WANG
1
;
Xianjie CHEN
1
;
Zhao LI
1
;
Guoqing LU
1
;
Zhenchang QI
1
;
Zhaoyun CHENG
1
Author Information
1. Department of Cardiac Surgery, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, 451464, P. R. China
- Publication Type:Journal Article
- Keywords:
Coronary heart disease;
minimally invasive surgery;
off-pump coronary artery bypass grafting;
multivessel coronary artery disease
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(10):1455-1461
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the early clinical efficacy of minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) via left intercostal small incision for multivessel coronary artery disease. Methods The patients who received off-pump CABG in the Central China Fuwai Hospital of Zhengzhou University from June 2021 to June 2023 were enrolled. Patients were divided into two groups according to the operative technique used, including a traditional midline sternotomy group and a left intercostal small incision group. The clinical data of the two groups were compared. Results A total of 143 patients were enrolled, including 70 patients in the traditional midline sternotomy group and 73 patients in the left intercostal small incision group. The age of the patients in the left intercostal small incision group and the traditional midline sternotomy group was (63.8±8.0) years and (63.0±7.8) years, respectively; the proportions of males were 69.9% and 74.3%, respectively. The differences were not statistically significant (all P>0.05). All patients in the two groups successfully completed the operation, and no patients in the left intercostal small incision group were converted to thoracotomy. The patients in the left intercostal small incision group showed less postoperative drainage within postoperative 24 hours [(239.4±177.7) mL vs. (338.0±151.9) mL, P<0.001], lower perioperative blood transfusion rate [32.9% (24/73) vs. 51.4% (36/70), P=0.028], higher postoperative myoglobin level within postoperative 24 hours [366.1 (247.9, 513.0) ng/mL vs. 220.8 (147.2, 314.9) ng/mL, P<0.001], shorter intensive care unit stay [45.5 (31.5, 67.5) h vs. 68.0 (46.0, 78.5) h, P=0.001] and postoperative hospital stay [(10.8±4.0) d vs. (13.1±5.3) d, P=0.028] compared to the traditional midline sternotomy group. There was no significant difference in the incidence of major adverse cardiac and cerebrovascular event between the two groups [2.7% (2/73) vs. 2.9% (2/70), P=1.000]. Conclusion Compared to the full median sternotomy, MICS CABG leads to a good clinical result with smaller trauma, faster overall recovery, and less perioperative blood transfusion.
