Postoperative results of minimally invasive direct coronary artery bypass thoracotomy versus off-pump coronary artery bypass sternotomy

Abstract

Background: Off-pump coronary artery bypass (OPCAB) is considered an important method for coronary surgery as it avoids many drawbacks to CPB e.g.: incidence of strokes, renal impairment, post-operative coagulopathy and bleeding especially with prolonged bypass times. this approach could be beneficial in reducing some of these drawbacks. Along with the evolution of off-pump techniques, we could perform these operations with minimally invasive direct coronary artery bypass (MIDCAB) through thoracotomy incisions adding the benefit of avoiding median sternotomy to the proposed benefits of off-pump. Objectives: to compare the early outcomes following OPCAB- sternotomy with MIDCAB- thoracotomy. Methods: between October, 2017 and April, 2018 thirty patients with single vessel (LAD) disease indicated for CABG divided into 15 patients underwent OPCAB- sternotomy and 15 patients underwent MIDCAB- thoracotomy. Results: MIDCAB had mean mechanical ventilation time of 4.93 (±3.058), blood transfusion was needed in 2 patients which was significantly different from OPCAB population. Conclusion: MIDCAB yielded shorter mechanical ventilation times and lower rate of blood transfusion, comparable results as regards the ICU, hospital stay and infection rate.