PORT-ACCESS MINIMALLY INVASIVE MULTI-VESSEL CABG IS ASSOCIATED WITH SHORT POST-OPERATIVE DURATION OF TRACHEAL INTUBATION, ICU STAY AND HOSPITAL STAY

Abstract

Introduction: Avoidance of a median sternotomy with minimally invasive cardiac surgery may alter the duration of post-operative tracheal intubation, intensive care stay, and hospitalization. Port-Access minimally invasive cardiac surgery uses a system of catheters and cannulae which permit cardiopulmonary bypass and myocardial protection to be achieved without accessing the heart via a median sternotomy. With this system, coronary artery bypass grafting is accomplished through a small intercostal incision. Methods: A multi-center, prospectively collected database of Port-Access cardiac surgery patients was queried with respect to duration of post-operative tracheal intubation (TI), intensive care stay (ICU), post-operative length of hospital stay (POLOS), pre-operative medical history, and perioperative morbidity and mortality. Certain centers participated in data collection by completing a simplified case report form which did not include TI, ICU and some elements of pre-operative medical history. POLOS, morbidity, and mortality data were collected for all patients. The database is maintained by an independent contract research organization and analyses are directed by a steering committee of cardiac physicians. The identified population was patients who received multi-vessel Port-Access CABG in the United States. Results: Between June 2, 1997 and August 25, 1998, 804 patients had multi-vessel Port-Access CABG (mean grafts=2.6) at 75 institutions with 579 patients reported on the simplified form. There were 10 (1.2%) peri-operative deaths, and these patients were excluded from further analysis. The following Table 1 and Table 2 describes results from the present study. To facilitate interpretation of these data, results from a University HealthSystem Consortium (UHC) study of 1,094 non-emergent, non-fatal, first time CABG procedures performed at 40 academic hospitals are also shown [1]:Table 1Table 2Conclusions: Port-Access minimally invasive multi-vessel CABG is associated with short post-operative duration of tracheal intubation, ICU stay and hospital stay. Further investigation will permit direct comparison of various surgical methods.