PDF(Pubmed)
Abstract：
Background: Coronary artery disease is a major cause of death globally. Minimally invasive direct coronary artery bypass (MIDCAB), using a small left anterior thoracotomy, aims to provide a less invasive alternative to traditional procedures, potentially improving patient outcomes with reduced recovery times. Methods: This retrospective, non-randomized study analyzed 310 patients who underwent MIDCAB between July 1999 and April 2022. Data were collected on demographics, clinical characteristics, operative and postoperative outcomes, and follow-up mortality and morbidity. Statistical analysis was conducted using IBM SPSS, with survival curves generated via the Kaplan-Meier method. Results: The cohort had a mean age of 63.3 ± 10.9 years, with 30.6% females. The majority of surgeries were elective (76.1%), with an average operating time of 129.7 ± 35.3 min. The median rate of intraoperative blood transfusions was 0.0 (CI 0.0-2.0) Units. The mean in-hospital stay was 8.7 ± 5.5 days, and the median ICU stay was just one day. Early postoperative complications were minimal, with a 0.64% in-hospital mortality rate. The 6-month and 1-year mortalities were 0.97%, with a 10-year survival rate of 94.3%. There were two cases of perioperative myocardial infarction and no instances of stroke or new onset dialysis. Conclusions: The MIDCAB approach demonstrates significant benefits in terms of patient recovery and long-term outcomes, offering a viable and effective alternative for patients suitable for less invasive procedures. Our results suggest that MIDCAB is a safe option with favorable survival rates, justifying its consideration in high-volume centers focused on minimally invasive techniques.
摘要：
背景：冠状动脉疾病是全球死亡的主要原因。微创直接冠状动脉搭桥术（MIDCAB），用左前胸小切开术，旨在为传统手术提供一种侵入性较小的替代方案，可能改善患者预后，减少恢复时间。方法：回顾性分析，非随机研究分析了在1999年7月至2022年4月期间接受MIDCAB的310例患者.收集了人口统计数据，临床特征,手术和术后结果，以及随访死亡率和发病率。使用IBMSPSS进行统计分析，通过Kaplan-Meier方法生成的存活曲线。结果：该队列的平均年龄为63.3±10.9岁，女性占30.6%。大多数手术是选择性的(76.1%)，平均运行时间为129.7±35.3min。术中输血的中位数为0.0（CI0.0-2.0）单位。平均住院时间为8.7±5.5天,ICU住院的中位数只有一天。术后早期并发症很少，住院死亡率为0.64%。6个月和1年死亡率为0.97%，10年生存率为94.3%。有2例围手术期心肌梗死，没有中风或新发作的透析病例。结论：MIDCAB方法在患者康复和长期预后方面显示出显著的益处。为患者提供了一个可行和有效的替代方案，适用于侵入性较小的程序。我们的结果表明，MIDCAB是一个安全的选择，具有良好的生存率，在专注于微创技术的高容量中心证明其考虑是合理的。
