Sixteen-year outcomes of patients undergoing minimally invasive direct coronary artery bypass surgery: a single-center experience

Abstract

Minimally invasive direct coronary artery bypass (MIDCAB) grafting is a safe technique for revascularization of the left anterior descending artery. The objective of this study was to evaluate the long-term outcomes of patients who underwent MIDCAB surgery in our institution. This was a retrospective, observational outcome study of retrospectively collected data. Data was collected using community, electronic, and paper medical records as well as telephone follow-up conversations with patients who underwent MIDCAB between December 1996 and June 2021. The primary outcome measure was mortality. Secondary outcomes included revascularization, myocardial infarction, and wound infection. Survival analysis was performed using the Kaplan–Meier method. A total of 215 patients were identified in the study period undergoing MIDCAB at our center. The median age was 77 years, and the cohort consisted of 180 (83.3%) of male patients. The median follow-up period was 16 years (12.1–17.7). At follow-up, freedom from repeat left anterior descending revascularization and from other vessels, revascularization was 96.7% and 89.1% respectively. Survival rates were 99.5%, 81.0%, and 45.2% survival at 1 year, 10 years, and 25 years respectively. Univariate analysis showed age (p < 0.01, Hazard ratio 1.08 confidence interval 1.05–1.11) and left ventricular function (p < 0.01, hazard ratio 2.40, confidence interval 1.66–3.45) as factors associated with mortality. Our single-center experience of MIDCAB demonstrated excellent long-term freedom from revascularization and other complications. Although limited by the retrospective nature, the study shows MIDCAB to be a safe procedure for definitive revascularization of the left anterior descending coronary artery.