Graft patency and completeness of revascularization in minimally
invasive multivessel coronary artery bypass surgery
Abstract
Objectives: Graft patency and completeness of revascularization were
analyzed in patients who underwent off-pump minimally invasive coronary
artery bypass grafting via left small thoracotomy. Methods: We
retrospectively reviewed the invasive angiography findings and clinical
data of 186 consecutive patients who underwent off-pump minimally
invasive coronary artery bypass grafting via left small thoracotomy. The
left internal thoracic artery and saphenous vein were used to bypass two
or more of three coronary artery systems: the left anterior descending
artery, left circumflex artery, or right coronary artery. Before
hospital discharge, invasive angiography was performed to assess graft
patency and completeness of revascularization. Clinical variables during
hospitalization and follow-up were collected and analyzed. Results: All
186 patients successfully underwent off-pump minimally invasive coronary
artery bypass grafting without conversion to sternotomy or assistance of
cardiopulmonary bypass. The mean graft number was 2.81 per patient
(range, 2–5), and the total number of grafts was 522. The in-hospital
mortality rate was 1.6% (3/186). A total of 181 of 186 (97.3%)
patients underwent postoperative invasive angiography. Among the 510
grafts assessed by angiography, the total graft patency rate was 96.3%
(491/510) [98.3% (171/174) for left internal thoracic artery grafts
and 95.2% (318/334) for saphenous vein grafts]. The rate of complete
revascularization was 98.8% (510/516) of the total grafts in 180 of 186
(96.8%) patients. Conclusions: Minimally invasive coronary artery
bypass grafting using left internal thoracic artery and saphenous vein
grafts provides acceptable graft patency and completeness of
revascularization for patients with multivessel disease.