Surgical results of video-assisted minimally invasive direct coronary artery bypass

Background. A video-assisted minimally invasive direct coronary artery bypass procedure is defined as a combination of video thoracoscopic internal mammary artery harvest and direct coronary bypass grafting through a minithoracotomy without cardiopulmonary bypass. We reviewed our experience with this procedure and examined its efficacy. Methods. Since November 1995, 110 patients have undergone a minimally invasive direct coronary artery bypass procedure in our institution. Seventy (64%) of them underwent a video-assisted minimally invasive operation (group 1). As a control group (group 2), we reviewed the results in 37 patients who underwent conventional single or double coronary artery bypass grafting using an internal mammary artery graft between 1993 and 1995 and could have been candidates for minimally invasive direct coronary artery bypass grafting. Results. There were two hospital deaths (2.9%) in group 1 and one hospital death (2.7%) in group 2. There were no significant differences in mortality or morbidity between the two groups. The number of patients who needed postoperative positive inotropic agents was significantly greater in group 2, and this group also had a significantly longer mean postoperative intubation time and mean hospital stay than group 1. Conclusions. The surgical results of video-assisted direct coronary artery bypass procedures were better than those of conventional coronary artery bypass grafting in this review. A long-term follow-up for graft patency is needed.