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Minimally Invasive Coronary Artery Bypass: Experience in 114 Patients

enol Yavuz, MD, M Adnan Celkan, MD, Cüneyt Eri, MD, Mustafa Mavi, MD, Tamer Türk, MD, Osman Tiryakiolu, MD, Yusuf Ata, MD, Vedat Koca, MD^,1, Ayhan Özdemir, MD

Department of Cardiovascular Surgery 1 Department of Cardiology Bursa Yüksek htisas Hospital Bursa, Turkey

For reprint information contact: enol Yavuz, MD Tel: 90 224 360 5055 Fax: 90 224 360 2928 Department of Cardiovascular Surgery, Bursa Yüksek htisas Hospital, Duaçinari 16330, Bursa, Turkey.

From February 1996 to May 1998, 114 patients underwent a small (6 to 8 cm) left anterior thoracotomy for single-vessel coronary artery bypass grafting on a beating heart. There were 85 men and 29 women with a mean age of 63.1 ± 9.4 years, ranging from 36 to 84 years, and a mean preoperative ejection fraction of 53.2% ± 6.9%. The left internal mammary artery was anastomosed to the left anterior descending coronary artery under direct vision without cardiopulmonary bypass. There was no mortality. Postoperative morbidity included superficial wound infection in 3 patients. The length of the left internal thoracic artery was insufficient in two patients and the radial artery was used as an extension. Sixty-five (57%) patients underwent repeat coronary angiography (49 early, 16 late) and all grafts were patent. On intraoperative transesophageal echocardio-graphy, no segmental wall motion was seen during local coronary occlusion. Mean operative time was 1.7 ± 0.3 hours. One hundred and three patients (90%) were discharged 2 to 4 days postoperatively. The mean follow-up was 21.7 months. Minimally invasive surgery for left anterior descending coronary artery revascu-larization was considered to be a simple and effective alternative to the standard operation or angioplasty in selected patients.