Abstract
Background Patients with combined valve and coronary artery disease are commonly performed by
standard median sternotomy approach for coronary artery bypass grafting (CABG) and
valve surgery. The purpose of this study is to describe our experience and show feasibility
and safety of minimally invasive approach to single or combined valve pathology with
single-vessel right coronary artery (RCA) disease, even if it is suitable to percutaneous
coronary intervention.
Methods This retrospective study comprised 28 consecutive patients who underwent single or
combined valve surgery concomitant right CABG through right anterior minithoracotomy
between February 2018 and December 2020. Preoperative evaluation, intraoperative,
and postoperative outcomes were reviewed and analyzed.
Results There were 12 men and 16 women. The mean age was 71.46 ± 6.82 years. Ten patients
were in New York Heart Association class III or IV. The mean cardiopulmonary bypass
and aortic cross-clamping times were 117.6 ± 21.3 and 98.1 ± 22.6 minutes, respectively.
The mean time to extubation was 9.7 ± 5.6 hours, the mean intensive care unit stay
was 37.4 ± 14.6 hours, and the mean hospital stay was 6.9 ± 3.2 days. There was one
patient who underwent reoperation for bleeding. There were no instances of postoperative
stroke, myocardial infarction, renal failure, or wound infection. The mean follow-up
was 19 ± 2.4 months.
Conclusion Presence of RCA lesion is not a contraindication for minimally invasive approach
in cases who underwent single or combined valve surgery. Combined valve surgery and
right CABG via right anterior minithoracotomy are a safe and feasible option to standard
median sternotomy surgery, even if RCA lesions seem suitable for stenting.
Keywords
minimally invasive surgery - valve surgery - CABG
