Clinical Investigation
Minimally invasive coronary artery bypass grafting versus off-pump: a propensity-matched study for patients with multi-vessel lesion
Liu Jiaji, Kong Qingyu, Chi Liqun, Xiao Wei, Liang Lin, Huang Yu, Pan Feng
Published 2022-03-25
Cite as Chin J Thorac Cardiovasc Surg, 2022, 38(3): 184-189. DOI: 10.3760/cma.j.cn112434-20200903-00406
Abstract
ObjectiveTo compare the perioperative outcomes and short-term graft patency between patients who underwent multivessel off-pump coronary artery bypass graft(OPCABG) via left intercoastal space or sternotomy.
MethodsBetween January 2017 and August 2019, 100 patients who underwent minimal invasive coronary artery bypass graft(MICS CABG) were compared with 235 patients who underwent OPCABG by single surgeon at our institute. Among them, 257 cases were male and 78 were female, aged 34 to 84 years, with mean age(61.35±8.79)years old. Due to important differences in patients’ characteristics, a propensity score-matched analysis based on 12 covariates was performed to match in a 1∶2 fashion. 82 patients(MICS group) were matched with 127 patients(OPCABG group). Surgical and postoperative outcomes were evaluated.
ResultsThere was no statistical difference of perioperative mortality, myocardial infarction, and stroke rate(P>0.05). In MICS group, use of internal thoracic artery was higher and conversion to cardiopulmonary bypass was lower(P<0.05), but reoperation, new onset atrial fibrillation , and the use of mechanical device were similar(P>0.05). In addition, operation duration was longer but transfusion rate, postoperative chest tube drainage within 24 hours and postoperative hospital stays were less in the MICS group(P<0.05). LIMA, vein and overall graft patency were similar in the two groups shown by postoperative one-year CTA(P>0.05).
ConclusionMICS CABG is safe and feasible for patients with multiple coronary lesions. It has similar in-hospital outcomes and short-term graft patency but less transfusion and faster recovery compared to conventional OPCABG via sternotomy.
Key words:
Minimal invasive; Propensity Score-matching; Multivessel off-pump coronary artery bypass grafting
Contributor Information
Liu Jiaji
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Kong Qingyu
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Chi Liqun
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Xiao Wei
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Liang Lin
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Huang Yu
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Pan Feng
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
