Minimally invasive total arterial graft revascularization via a left minithoracotomy for multivessel coronary artery disease

Abstract

Objective To evaluate the outcomes achieved by using left internal mammary artery(LIMA) to radial artery(RA) total arterial composite grafts in minimally invasive direct coronary artery bypass grafting(MIDCAB) for patients with multiple vessel disease. Methods From January 2009 to September 2015, 39 patients(24 males) with multiple vessel disease underwent MIDCAB with LIMA-RA total arterial composite grafts without cardiopulmonary bypass in our hospital. MIDCAB was performed through a left anterior minithoracotomy. Results All patients successfully underwent MIDCAB with LIMA-RA total arterial composite grafts. No patient required to convert to strenotomy during the surgery. Mean operation time was(176.1±14.1)min. Revascularization was performed for 2 target vessels in 11 cases, 3 target vessels in 25 cases and 4 target vessels in 3 cases. Mean postoperative ventilation time was(21.9±27.9) h. Mean ICU time was(2.8±2.1) days, and mean postoperative inhosptial time was(11.2±3.3)days. There was no early death in perioperation. At a follow-up of 6 to 86 months[average(27.5±18.0) months], one patient died. The overall survival at 2 years postoperatively was(96.0±3.9)%. The patency rate of LIMA was 100%. The overall patency rate of RA grafts at 2 years postoperatively was(91.8±4.0)%. Conclusion MIDCAB with LIMA-RA total arterial composite grafts is a safe and effective procedure with favorable early and mid-term outcomes for patients with multiple vessel disease. Key words: Surgical procedures, minimally invasive; Coronary artery bypass, off-pump; Left internal mammary artery; Radial artery