Minimally invasive coronary artery bypass grafting for the treatment of multivessel coronary artery disease: a prognostic study
10.3760/cma.j.cn112434-20240522-00140
- VernacularTitle:经左胸前外侧小切口微创冠状动脉旁路移植术治疗冠状动脉多支病变的预后研究
- Author:
Chenhao ZHANG
1
;
Guoqing LI
1
;
Zhaofei YE
1
;
Guangpeng ZHAO
1
;
Ji LIN
1
;
Ping LI
1
Author Information
1. 首都医科大学附属北京安贞医院心外科，北京市心肺血管疾病研究所，北京 100029
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass grafting;
Minimally invasive;
Multiple coronary artery lesions;
Major adverse cardiovascular and cerebral events
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(4):206-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and mid-term efficacy of minimally invasive cardiac surgery coronary artery bypass grafting(MICS CABG) in the treatment of multi-vessel coronary artery disease.Methods:A retrospective analysis was conducted on 440 patients with multi-vessel coronary artery disease at the Minimally Invasive Cardiac Surgery Center of Beijing Anzhen Hospital, Capital Medical University, from January 2018 to December 2022. Among these patients, 145 who underwent MICS CABG were designated as the experimental group(MICS group). And 295 patients who underwent conventional sternotomy off-pump coronary artery bypass grafting(OPCABG) were collected during the same period. Propensity score matching was employed at a 1∶1 ratio to match patients in the OPCABG group, serving as the control group.The clinical data during hospitalization and the results of midterm follow-up were analyzed and compared using rank- sum test, Fisher' s exact test, Kaplan- Meier survival curve, and other methods. Results:After propensity matching, the baseline features were well balanced between the two groups( P>0.05), with 111 patients in each group. Patients who received MICS CABG had significantly reduce blood loss[MICS: 600 ml(500 ml, 900 ml) vs. OPCABG: 800 ml(600 ml, 1 000 ml), P<0.001], transfusion rate(MICS: 1.8% vs. OPCABG: 17.1%, P<0.001), and IABP implantation rate(MICS: 3.1% vs. OPCABG: 17.1%, P=0.001). In addition, patients who received MICS CABG had significantly better postoperative LVEF(MICS: 0.59±0.06 vs. OPCABG: 0.56±0.09, P<0.001) than the control group. The average follow-up time was 2.42 years, and there was no significant difference in the incidence of MACCEs in the mid-term( P=0.748). Conclusion:MICS CABG demonstrates rapid recovery and fewer postoperative complications. For patients with multiple coronary artery lesions, MICS CABG has a similar efficacy in the mid-term as conventional coronary artery bypass surgery.
