Comparison of sternotomy off-pump coronary artery bypass and minimally invasive technique for isolated single vessel grafting
Wu, Y.; Gao, C.-q.; Yang, M.; Xiao, C.-s.; Liu, G.-p.
Zhonghua Yi Xue Za Zhi 92(14): 974-976
2012
ISSN/ISBN: 0376-2491 PMID: 22781571 Document Number: 656225
To compare the outcomes of minimally invasive coronary artery bypass grafting operation performed via a small thoracotomy versus da Vinci S system (Endo-A-CAB) with sternotomy off-pump coronary artery bypass grafting (OPCAB) for single vessel lesion. From April 2000 to August 2011, a total of 194 patients with single coronary artery stenosis accepted CABG on beating heart were divided into 2 groups by different surgical approaches. Group A (n = 99) received sternotomy OPCAB while Group B (n = 95) underwent Endo-A-CAB. All patients had a history of unstable angina and coronary arteriography showed severe stenosis in left anterior descending artery (LAD). The procedure performed in Group B included robotic internal mammary artery (IMA) harvesting and single manual anastomosis to LAD and/or diagonal branch through small incision thoracotomy. IMA flow was evaluated by the Doppler flow meter after the completion of anastomosis. Grafting patency was evaluated postoperatively by computed tomography angiography (CTA) or angiography. The ventilation time and postoperative drainage volume in Group B were less than those in Group A ((5.1 ± 2.1) vs (10.1 ± 5.8) h, P = 0.03; (411 ± 295) vs (605 ± 244) ml, P = 0.000). No significant difference existed in blood flow, mortality and postoperative complication morbidity between two groups. All symptoms of angina disappeared. As a new advanced modality of revascularization, in comparison with OPCAB, Endo-A-CAB procedure is a less invasive and safer method of coronary artery bypass grafting for single vessel lesion.