Abstract
Minimally invasive direct coronary artery bypass (MIDCAB) surgery has been shown to be a promising technique for surgical treatment of single or double vessel disease. However, little is known about quality of life, mood state or coping in this group of patients. The records of 55 consecutive patients who underwent MIDCAB surgery at Harefield Hospital between April 1999 and May 2001 were reviewed. In order to assess quality of life, mood state and coping, patients were contacted by telephone to conduct a semi-structured interview and were subsequently sent four questionnaires. The measures used were the Hospital Anxiety and Depression Scale, the Short Form Health Survey, the WHOQoL-BREF and the COPE. Forty-eight patients were contacted by telephone, forty-four of whom returned the completed questionnaires. Overall ratings of quality of life were excellent for the majority of patients, and rates of anxiety and depression were lower than previously found following coronary artery bypass surgery. It is concluded that following MIDCAB surgery quality of life and mood state outcomes are encouraging. However, a prospective, longitudinal study is now required to further elucidate the relationship between quality of life, mood state and coping and to identify predictive factors for physical and psychological outcome following this new surgical technique.
Similar content being viewed by others
References
Jenkins CD, Stanton B-A, Jono RT. Quantifying and predicting recovery after heart surgery. Psychosom Med 1994; 56: 203-212.
Stengrevics, Sirois C, Schwartz CE, et al. The prediction of cardiac surgery outcome based upon preoperative psychological factors. Psychol Health 1996; 11: 471-477.
Duits AA, Boeke S, Taams MA, et al. Prediction of quality of life after coronary artery bypass graft surgery: A review and evaluation of multiple, recent studies. Psychosom Med 1997; 59: 257-268.
Vingerhoets G. Cognitive, emotional and psychsomatic complaints and their relation to emotional status and personality following cardiac surgery. Br J Health Psychol 1998; 3: 159-169.
Selnes OA, Goldsborough MA, Borowicz LM, McKhann GM. Neurobehavioural sequelae of cardiopulmonary bypass. Lancet 1999; 353: 1601-1606.
Duits AA, Boeke S, Duivenvoorden HJ, Passchier J. Depression in patients undergoing cardiac surgery: A comment. Br J Health Psychol 1996; 1: 283-286.
Caine N, Harrison SC, Sharples LD, Wallwork J. Prospective study of quality of life before and after coronary artery bypass grafting. Br Med J 1991; 302: 511-516.
Blumenthal JA, Mark DB. Quality of life and recovery after cardiac surgery. Editorial comment. Psychosom Med 1994; 56: 213-215.
Stanton BA, Jenkins CD, Savageau JA, Thurer RL. Functional benefits following coronary artery bypass graft surgery. Ann Thorac Surg 1984; 37: 286-290.
Jenkins CD, Stanton BA, Savageau JA, et al. Coronary artery bypass surgery. Physical, psychological, social, and economic outcomes six months later. J Am Med Assoc 1983; 250: 782-788.
King KB, Reis HT, Porter LA, Norsen LH. Social support and long-term recovery from coronary artery surgery: Effects on patients and spouses. Health Psychol 1993; 12: 56-63.
Allen JK. Physical and psychosocial outcomes after coronary artery bypass graft surgery. Review of the literature. Heart Lung 1990; 19: 49-54.
Kulik JA, Mahler HIM. Emotional support as a moderator of adjustment and compliance after coronary artery bypass surgery: A longitudinal study. J Behav Med 1993; 16: 45-63.
Sjoland H, Wiklund I, Caidahl K, et al. Improvement in quality of life and exercise capacity after coronary bypass surgery. Arch Inter Med 1996; 156: 265-271.
Scheier MF, Matthews KA, Owens JF, et al. Dispositional optimism and recovery from coronary artery bypass surgery: The beneficial effects on physical and psychological well-being. J Pers Soc Psychol 1989; 57: 1024-1040.
Hagen JW. Psychological adjustment following coronary artery bypass graft surgery. Rehabil Couns Bull 1991; 35: 97-104.
Strauss B, Paulsen G, Strenge H, et al. Preoperative and late postoperative psychosocial state following coronary artery bypass surgery. Thorac Cardiovasc Surg 1992; 40: 59-64.
Magni G, Unger HP, Valfre C, et al. Psychosocial outcome one year after heart surgery. A prospective study. Arch Intern Med 1987; 147: 473-477.
Langeluddecke P, Fulcher G, Baird D, et al. A prospective evaluation of the psychosocial effects of coronary artery bypass surgery. J Psychosom Res 1989; 33: 37-45.
Mayou R, Bryant B. Quality of life after coronary artery surgery. Q J Med 1987; 62: 239-248.
Skevington SM, Carse MS, de Williams AC. Validation of the WHOQoL-100: Pain management improves quality of life for chronic pain patients. Clin J Pain 2001; 17: 264-275.
Skevington SM, Wright A. Changes in the quality of life of patients receiving anti-depressant medication in primary care: Validating the WHOQoL-100. Br J Psychiat 2001; 178: 261-267.
Lowe R, Norman P, Bennett P. Coping, emotion and perceived health following myocardial infarction: Concurrent and predictive associations. Br J Health Psychol 2000; 5: 337-350.
Boudrez H, De Backer G. Psychological status and the role of coping style after coronary artery bypass graft surgery. Results of a prospective study. Qual Life Res 2001; 10: 37-47.
Subramanian VA, Sani G, Benetti FJ, Calafiore AM. Minimally invasive coronary bypass surgery: A multi-centre report of preliminary clinical experience. Circulation 1995; 92: 1645.
Diegeler A, Falk V, Walther T, Mohr FW. Minimally invasive coronary artery bypass without extracorporeal circulation. N Engl J Med 1997; 336: 1454-1455.
Mehran R, Dangas G, Stamou S, et al. One-year clinical outcome after minimally invasive direct coronary artery bypass. Circulation 2000; 102: 2799-2802.
Verkkala K, Voutilainen S, Jarvinen A, et al. Minimally invasive coronary artery bypass grafting: One-year follow up. J Cardiac Surg 1999; 14: 231-237.
Cremer J, Mugge A, Wittwer T, et al. Early angiographic results after revascularization by minimally invasive direct coronary artery bypass (MIDCAB). Eur J Cardiothor Surg 1999; 15: 383-387.
Katz W, Zenati M, Mandarino W, et al. Assessment of left internal mammary artery graft patency and flow reserve after minimally invasive direct coronary artery bypass. Am J Cardiol 1999; 84: 795-801.
Holubkov R, Zenati M, Akin J, et al. MIDCAB Characteristics and results: The CardioThoracic Systems (CTS) registry. Eur J Cardiothor Surg 1998; 14: S25-S30.
Diegeler A, Walther T, Metz S, et al. Comparison of MIDCAB versus conventional CABG surgery regarding pain and quality of life. Heart Surg Forum 1999; 2: 290-296.
Al-Ruzzeh S, Mazrani W, Wray J, et al. The clinical outcome and quality of life following minimally invasive direct coronary artery bypass (MIDCAB) surgery. J Cardiac Surg (In Press).
Ware JE, Snow KK, Kosinski M, et al. SF-36 Health Survey Manual and Interpretation Guide. Boston MA: Medical Outcomes Trust, 1993.
Smith HJ, Taylor R, Mitchell A. A comparison of four quality of life instruments in cardiac patients: SF-36, QLI, QLMI and SEIQoL. Heart 2000; 84: 390-394.
The WHOQoL Group. Development of the World Health Organization WHOQoL-BREF quality of life assessment. Psychol Med 1998; 28: 551-558.
O'Carroll RE, Smith K, Couston M, et al. A comparison of the WHOQoL-100 and the WHOQoL-BREF in detecting change in quality of life following liver transplantation. Qual Life Res 2000; 9: 121-124.
Zigmond A, Snaith R. The Hospital Anxiety and Depression Scale. Acta Psychiat Scand 1983; 67: 361-370.
Johnston M, Pollard B, Hennessey P. Construct validation of the hospital anxiety and depression scale with clinical populations. J Psychosom Res 2000; 48: 579-584.
Hetzer R, Albert W, Hummel M, et al. Status of patients presently living 9 to 13 years after orthotopic heart transplantation. Ann Thorac Surg 1997; 64: 1661-1668.
Herrmann C. International experiences with the Hospital Anxiety and Depression Scale — a review of validation data and clinical results. J Psychosom Res 1997; 42: 17-41.
Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol 1989; 56: 267-283.
Jenkinson C, Coulter A, Wright L. Short form 36 (SF 36) health survey questionnaire: Normative data for adults of working age. Br Med J 1993; 306: 1437-1440.
McHorney CA, Tarlov AR. Individual patient monitoring in clinical practice: Are available health status surveys adequate? Qual Life Res 1995; 4: 293-307.
Wolinsky FD, Wyrwich KW, Nienaber NA, Tierney WM. Generic versus disease-specific health status measures. Eval Health Prof 1998; 21: 216-243.
Dexter PR, Stump TE, Tierney WM, Wolinsky FD. The psychometric properties of the SF-36 health survey among older adults in a clinical setting. J Clin Geropsychol 1996; 2: 225-237.
McHorney CA. Measuring and monitoring general health status in the elderly: Practical and methodological issues in using the SF-36 health survey. Gerontologist 1996; 36: 571-583.
Wolinsky FD, Stump TE. A measurement model of the Medical Outcomes Study 36-item short-form health survey in a clinical sample of disadvantaged, older, black, and white men and women. Med Care 1996; 34: 537-548.
O'Mahony PG, Rodgers H, Thomson RG, et al. Is the SF-36 suitable for assessing health status of older stroke patients? Age Ageing 1998; 27: 19-22.
Suarez-Almazor ME, Kendall C, Johnson JA, et al. Use of health status measures in patients with low back pain in clinical settings. Comparison of specific, generic and preference-based instruments. Rheumatology 2000; 39: 783-790.
Hobart JC, Williams LS, Moran K, Thompson AJ. Quality of life measurement after stroke: Uses and abuses of the SF-36. Stroke 2002; 33: 1348-1356.
Mayou R. Clinical significance of research on quality of life after coronary artery surgery. In: Walter PJ (ed), Quality of Life after Open Heart Surgery. Dordrecht, The Netherlands: Kluwer Academic Publishers, 1992; 185-192.
Pignay-Demaria V, Lesperance F, Demaria RG, et al. Depression and anxiety and outcomes of coronary artery bypass surgery. Ann Thorac Surg 2002; 75: 314-321.
Andrews MJ, Baker RA, Kneebone AC, Knight JL. Mood state as a predictor of neuropsychological deficits following cardiac surgery. J Psychosom Res 2000; 48: 537-546.
Vingerhoets G, De Soete G, Jannes C. Subjective complaints versus neuropsychological test performance after cardiopulmonary bypass. J Psychosom Res 1995; 39: 843-853.
McKhann GM, Goldsborough MA, Borowicz Jr LM, et al. Cognitive outcome after coronary artery bypass: A one-year prospective study. Ann Thorac Surg 1997; 63: 510-515.
Roach GW, Kanchuger M, Mangano CM, et al. Adverse cerebral outcomes after coronary bypass surgery. N Engl J Med 1996; 335: 1857-1863.
Kroenke K, Jackson JL, Chamberlin J. Depressive and anxiety disorders in patients presenting with physical complaints: Clinical predictors and outcome. Am J Med 1997; 103: 339-347.
Carver CS, Pozo C, Harris SD, et al. How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. J Pers Soc Psychol 1993; 65: 375-390.
Ingledew DK, Hardy L, Cooper CL, Jemal H. Health behaviours reported as coping strategies: A factor analytical study. Br J Health Psychol 1996; 1: 263-281.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wray, J., Al-Ruzzeh, S., Mazrani, W. et al. Quality of Life and Coping Following Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) Surgery. Qual Life Res 13, 915–924 (2004). https://doi.org/10.1023/B:QURE.0000025600.56517.c5
Issue Date:
DOI: https://doi.org/10.1023/B:QURE.0000025600.56517.c5