PDF(Pubmed)
Abstract：
Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative for revascularisation of the isolated left anterior descending (LAD) artery or as a multi-vessel (MV) procedure for the diagonal branch (RD) or the left circumflex coronary artery (LCX) region. Methods: From 2021 to 2022, 91 patients underwent MIDCAB or multi-vessel MIDCAB procedures in our heart center. The left internal mammary artery (LIMA) was anastomosed to the left anterior descending artery via the left minithoracotomy approach in all patients. Results: Of the patients, a total of 86.8% were male. Eighty percent of the patients had two- or three-vessel coronary artery disease. The mean age was 65.1 ± 10.1 years. The mean operation time was 2.6 ± 0.8 h. The 30-day mortality was 0. The mean required packed red blood cells (pRBC) was 0.4 ± 1.2 unit. The mean intensive care unit stay (ICU) was 1.5 ± 1.6 days. The mean follow-up time was 1.5 ± 0.5 years. One patient received percutaneous coronary intervention due to de novo stenosis of the RCA. Late mortality was 2.2%. The Kaplan-Meier survival rate was 98.8% at 1 and 2 years. Conclusions: The postoperative complication rate of our MIDCAB cohort is low, and the short-term survival is favorable. Our postoperative and short-term clinical results demonstrate that this procedure is safe and feasible.
摘要：
目标：微创直接冠状动脉搭桥术（MIDCAB）是孤立的左前降支（LAD）动脉血运重建的替代方法，也可以作为对角支（RD）或左回旋支（LCX）区域的多血管（MV）手术。方法：从2021年到2022年，91例患者在我们的心脏中心接受了MIDCAB或多血管MIDCAB手术。所有患者均通过左胸小切口手术将左乳内动脉（LIMA）与左前降支吻合。结果：在患者中，共有86.8%为男性。80%的患者患有两支或三支冠状动脉疾病。平均年龄为65.1±10.1岁。平均手术时间为2.6±0.8h。30天死亡率为0。平均所需的压积红细胞（pRBC）为0.4±1.2单位。重症监护病房（ICU）平均住院时间为1.5±1.6天。平均随访时间为1.5±0.5年。由于RCA的新狭窄，一名患者接受了经皮冠状动脉介入治疗。晚期死亡率为2.2%。Kaplan-Meier1年和2年生存率为98.8%。结论：我们的MIDCAB队列的术后并发症发生率较低，短期生存是有利的。我们的术后和短期临床结果表明，该程序是安全可行的。
