Abstract

Although most coronary artery bypass grafting (CABG) operations are performed through middle sternotomy using extracorporeal circulation, minimally invasive myocardial revascularization is increasingly being used in myocardial revascularization. Minimally invasive coronary artery bypass grafting is a revolutionary trend in cardiac surgery. Thanks to the use of modern high-tech means, patients with coronary heart disease undergo multiple coronary artery bypass grafting without extracorporeal circulation through a left-sided minithoracotomy. Minimally invasive cardiac surgery Coronary Artery Bypass Grafting (MICS CABG) is an attractive, possibly more suitable method than classic CABG, accompanied by minimal complications. This technique is safe, effective, and provides outstanding patient comfort and the possibility of safe re-access in the future, when myocardial ischemia returns. This technique provides good long-term results, comparable to conventional CABG. However, there is a group of patients in whom it is impossible to safely perform this operation (relative insufficiency of heart valves, cardiac arrhythmia, low ejection fraction of the left ventricle). These patients can undergo CABG using minimally invasive extracorporeal circulation.
Purpose: The aim of the study was to demonstrate the first experience of using the MiECC technique in MICS CABG with the assessment of hospital outcomes.
Material and methods: From January 2015 to January 2023, 89 mini-invasive CABG surgeries were performed in our department through left-sided mini-thoracotomy, of which seven operations were performed using a minimally invasive extracorporeal circuit of the first type.
Outcomes: In the group with MiECC in MICS CABG, there were no myocardial infarctions or deaths.
Conclusion: The use of MiECC in MICS provides good in-hospital outcomes and can be used as a safe alternative for myocardial revascularization in primary and recurrent patients with CAD.

Keywords

coronary bypass surgery; thoracotomy, extracorporeal circulation, MICSCAB