Single Center Experience in Minimally Invasive Coronary Artery Bypass grafting (MIDCAB) procedures, Tel Aviv Sourasky Medical Center

Objective:
Minimally invasive cardiac surgery has become an important therapeutic approach in the armamentarium of cardiac surgeons. We report a single center (the Tel Aviv Sourasky medical center) experience with this strategy in the last fifteen years.

Methods:
We followed medical records and the ministry of internal affairs mortality database for all patients operated using a minimally invasive cardiac procedure without a conventional sternotomy in our center between September 2000 to February 2016. Major cases included: minimally invasive direct coronary artery bypass procedures (MIDCAB`s), Aortic valve replacement, Mitral valve repair or replacement, repair of atrial septal defect, Tricuspid valve repair, resection of atrial Myxomas and Maze procedures. All patients were evaluated for early and late mortality and for major complication rate.

Results:
There were one hundred and forty MIDCAB`s during the study period, all preformed in left anterior mini thoracotomy on a beating heart without the use of heart lung machine. There was a 1.4% (two patients) early (thirty day) mortality. Median follow up period was 163 (1-196) months. Mean age of the whole group was 65.4 years, with 26.5% female patients. Long term survival for the whole group during the study period was 71.3%. Age was not found to be associated with early mortality.

Conclusion:
Minimally Invasive Direct coronary artery bypass grafting (MIDCAB) procedures for revascularization of the left anterior descending artery are safe and reproducible.