Original article: cardiovascularMinimally invasive single-vessel coronary artery bypass with the internal thoracic artery and early postoperative angiography: midterm results of a prospective study in 120 consecutive patients
Section snippets
Patients and methods
This study was approved by the University of São Paulo School of Medicine Scientific and Ethics Committee. All patients gave informed consent to undergo MIDCAB and early routine postoperative angiography. From November 1995 to December 1998, 120 consecutive patients with single-vessel coronary artery disease with normal ventricular function or mild dysfunction (ejection fraction between 0.35 and 0.55) were prospectively selected to undergo MIDCAB. All patients presented symptomatic
Results
In 115 (95.8%) patients, the operation was conducted with the minimal access approach on a beating heart; in 5 patients (4.2%) the MIDCAB was converted to a median sternotomy. In 4 of these patients, the conversion resulted from an insufficient length of the ITA or different coronary artery anatomy, including intramyocardial artery or a lateralized coronary artery. One patient had urgent conversion because of a small right ventricular rupture, during the LAD snare. All 5 patients had uneventful
Comment
We performed MIDCAB using ITA in 120 consecutive patients with symptomatic, isolated stenosis in the LAD or RCA and no major ventricular dysfunction. Our results support the concept that MIDCAB is a safe operation, and could be an alternative to conventional CABG, with similar graft patency and midterm results.
Concerns regarding anastomosis accuracy after MIDCAB led some surgeons, including us, to routinely evaluate, with angiography, ITA patency and the aspect of coronary artery anastomosis.
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