Abstract

Our study emerges against the backdrop of ongoing advancements in cardiac surgery, specifically within the realm of minimally invasive approaches for coronary artery bypass grafting (CABG). As medical practices continually refine their techniques for improved patient outcomes, a critical examination of the efficacy of these procedures becomes imperative. Aim and Objectives: To investigate the evolving landscape of cardiac surgical methodologies, focusing on the intricacies and ramifications of minimally invasive cardiac surgery. Materials and Methods: This retrospective study analyzes outcomes in the initial 100 patients undergoing Minimally Invasive Coronary Artery Bypass Grafting (MICS CABG) at our institution from January 2021 to December 2022. Conducted by a single experienced surgeon, the study documents early MICS CABG experiences and compares them with conventional CABG via sternotomy. Inclusion criteria encompassed MICS suitability, while exclusion criteria considered factors like valvular pathology and previous cardiac surgery. Results: Patients, averaging 45.3 years old, showed a male predominance (2.45:1) and common cardiovascular risk factors, including 44% with diabetes, 65% with hypertension, and 28% with chronic obstructive pulmonary disease. Coronary artery disease distribution was 37% single vessel disease, 41% double vessel disease, 22% triple vessel disease, and 26% left main coronary artery disease. The pre-op ejection fraction was 37±7.8%, and 9% experienced cardiogenic shock. Intra-operatively, 97% of surgeries were off-pump, with a mean incision size of 7.2±0.5 cm. Postoperatively patient’s demonstrated quick recovery with no significant complications. Our study affirms that MICS CABG demonstrates comparable comfort for the operator when addressing multivessel disease, akin to single- or double-vessel cases. Conclusion: Our findings parallel the observation that, in certain instances, there may be a temporary increase in operating time for MICS CABG compared to sternotomy. However, consistent with the cited example, our study reveals no significant difference in postoperative adverse events between MICS and sternotomy. Importantly, our investigation supports the advantages of MICS over sternotomy in immediate postoperative aspects, including reduced ventilation time, mean drainage, postoperative discomfort, and shorter intensive care unit and hospital stays.

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