High-risk patients with multivessel disease--is there a role for incomplete myocardial revascularization via minimally invasive direct coronary artery bypass grafting?

The Heart Surgery Forum
Stephan JacobsFriedrich W Mohr

Abstract

Patients with multivessel disease with high predicted mortality for conventional coronary artery bypass grafting (CABG) and the left anterior descending coronary artery (LAD) as the major target vessel may be suitable for minimally invasive direct coronary artery bypass (MIDCAB) despite incomplete revascularization. From January 1997 to December 2005, MIDCAB was performed in 80 patients (mean age 70 +/- 11.3 years) with multivessel disease. Predicted mortality was 10.2% calculated by the logistic Euroscore. Results were analyzed retrospectively for mortality, morbidity, operation time, and event-free survival, including freedom from angina, major adverse cardiac events (MACE), and reintervention. Mean operating time was 100 +/- 31 minutes. There was one in-hospital death (1.25%). Four patients (5%) had to be reoperated on, 2 via the minithoracotomy incision and 2 via sternotomy. Follow-up was completed in 87% of patients. During follow-up (26 months), 9 patients died. The cause of death was cardiac in 1 patient, noncardiac in 3 patients, and unknown in 5 patients. Two patients required reoperation because of progressive atherosclerosis, and 2 patients because of progressive valve disease. The actuarial 4-year survival was 85.6%...Continue Reading

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Citations

May 15, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Frank W SellkeWilliam E Cohn
May 13, 2014·Indian Heart Journal·Shantanu PandeSushil P Ambesh
Jul 4, 2012·The Annals of Thoracic Surgery·Nicolas GirerdPatrick Mathieu
May 23, 2016·Interactive Cardiovascular and Thoracic Surgery·Grischa HoffmannJochen Cremer
May 28, 2021·The Thoracic and Cardiovascular Surgeon·Grischa HoffmannChristina Grothusen
Sep 7, 2021·Current Opinion in Cardiology·Katsuhiro HosoyamaYoshikatsu Saiki

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