Background: Coronary bypass surgery can be performed less invasively by avoiding cardiopulmonary bypass (OPCAB) and by performing a minimally invasive direct coronary artery bypass through a left anterior mini-thoracotomy (MIDCAB). We compared our early results in patients with single vessel disease who underwent OPCAB and MIDCAB without cardiopulmonary bypass.
METHODS: Forty-four patients who underwent LIMA to LAD either by MIDCAB or OPCAB between January 2013 and December 2014 were reviewed. Data were obtained retrospectively. Patients undergoing MIDCAB or OPCAB were compared in terms of gender, preoperative risk factors, length of operation, ventilation time, ICU and hospital stay, amount of postoperative bleeding, daily postoperative pain (0-10 scale), and troponin and creatinine levels.
Results: A total of 20 patients in the MIDCAB group and 24 in the OPCAB group were analyzed. There was no mortality in the MIDCAB group, versus two patient deaths in the OPCAB group (P=0.186). No significant differences were observed between the two groups with respect to gender, preoperative risk factors, ventilation time, ICU and hospital stay, amount of postoperative bleeding, and troponin and creatinine levels. The MIDCAB procedure duration was longer compared to the OPCAB [median (IQR): 151 (139.75-176.5) vs. 132 (102-162) min, respectively; P=0.029]. Patients undergoing MIDCAB reported greater pain scores on the 2nd postoperative day [5(2-5) vs. 2 (0-3.5), respectively; P=0.027], and similar low pain scores on the 5th postoperative day [0.0 (0-2) vs. 0.0 (0-4), respectively; P=0.142].
Conclusions: MIDCAB procedures can be performed safely in well-selected patients with low postoperative morbidity and mortality. The higher pain scores during the early postoperative period in the MIDCAB group should be treated more vigorously.
