Abstract
Background Coronary artery bypass grafting (CABG) using bilateral internal thoracic artery (BITA)
is associated with the best long-term survival. However, using BITA increases the
risk of sternal wound infections with conventional sternotomy. We describe here our
initial results of minimally invasive CABG (MICS-CABG) using BITA.
Methods Patients were operated through an incision similar to that of standard minimally
invasive direct CABG. All operations were performed off-pump. We evaluated patient's
quality of life (QoL) using the Medical Outcomes trust, 36-Item Short Form Health
Survey (SF-36).
Results Between February 2016 and August 2017, we performed 21 cases of MICS-CABG using BITA.
There was no intraoperative complication and no conversion to sternotomy or to on-pump.
Two patients required reexploration through the same minithoracotomy for postoperative
bleeding. Two cases of early postoperative graft failure were identified. There was
no stroke or in-hospital mortality. The median duration of follow-up was 13 months,
with a maximum of 19 months. Relief of angina was achieved in all patients. There
was one readmission for superficial wound infection, which was conservatively treated.
An 84-year-old man died 4 months after the operation. The remaining 20 patients attested
good QoL with the SF-36 questionnaire.
Conclusions Myocardial revascularization using BITA can be safely achieved off-pump through a
left-sided minithoracotomy with good postoperative and short-term outcomes.
Keywords
coronary artery bypass grafting - bilateral internal thoracic arteries - minimally
invasive - mortality
