Study on the perioperative coronary angiography results and surgical safety of 1 073 cases of multi-vessel CABG with left thoracic small incision
10.3760/cma.j.cn112434-20241206-00308
- VernacularTitle:1 073例左胸小切口多支CABG围手术期冠状动脉造影结果及手术安全性研究
- Author:
Yichen GONG
1
;
Yunpeng LING
1
;
Wei YANG
1
;
Luyu MENG
1
;
Zhongqi CUI
1
;
Song WU
1
;
Yuanhao FU
1
;
Hui ZHENG
1
Author Information
1. 北京大学第三医院心脏外科，北京 100191
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass grafting;
Minimally invasive cardiac surgery;
Patency rate of bypass graft;
Coronary angiography
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(6):359-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the safety and efficacy of multi-vessel minimally invasive cardiac surgery-coronary artery bypass graft(MICS-CABG) through perioperative angiography results and complications.Methods:Clinical data of 1 073 patients who underwent multi-vessel MICS-CABG surgery at Peking University Third Hospital from December 2015 to June 2024 were collected using an ambispective cohort study. Among them, 745 were males(69.4%), with a median age of 65 years(58, 71), and a median ejection fraction of 0.66(0.56, 0.71). Double-vessel or triple-vessel lesions accounted for 932 cases(86.9%), while left main lesions were present in 449 cases(41.8%). The primary outcome was the evaluation of graft patency based on perioperative angiography or coronary artery computed tomography angiography results, while major cardiovascular adverse events during the perioperative period, surgical complications, and other surgical information were secondary outcomes. The clinical efficacy of multi-vessel MICS-CABG was evaluated.Results:In this study, the median number of grafts was 3, and complete revascularization was performed in 1 006 cases(93.8%); total arterial revascularization was performed in 308 cases(28.6%). Perioperative mortality was 11 cases(1.0%), and the main adverse cardiovascular and cerebrovascular events(MACCE) was 50 cases(4.8%). Three cases(0.3%) had poor wound healing, and 79 patients(7.4%) required transfusion. Postoperative coronary angiography was performed in 907 patients(84.5%) and coronary CTA was performed in 52 patients(4.8%), for an overall review rate of 89.4%(959/1073). The overall patency rate of the bridge vessel was 96.9%, and the patency rate of the left internal mammary artery was 98.2%.Conclusion:Multi-vessel MICS-CABG demonstrates excellent perioperative safety and is capable of achieving complete revascularization for the 3 regions of the heart. The quality of the anastomosis and the postoperative patency rate of the grafts is satisfactory.
