Comparison of postoperative pain and quality of life between left anterior thoracotomy and median sternotomy off-pump coronary artery bypass surgery in multivessel coronary revascularization: a retrospective study of a case series of 356 consecutive patients.

Abstract

Background: This study compared post-operative pain and quality of life (QoL) between left anterior thoracotomy (LAT) and median sternotomy (MS) in off-pump coronary artery bypass grafting (OPCAB). LAT is a less invasive alternative to MS for the treatment of advanced coronary artery disease.

Methods: This retrospective study analysed 356 patients who underwent OPCAB for multivessel revascularization between January 2018 and April 2023. Patients were divided into LAT (n = 169) and MS (n = 187) groups. Postoperative pain was measured using a Visual Analog Scale (VAS). QoL was assessed using the Short Form-36 (SF-36) questionnaire preoperatively and postoperatively.

Results: Patients with LAT had significantly lower pain scores on postoperative days 1, 3, and 7 (p < 0.001) than those with MS. LAT was associated with shorter ICU and hospital stay (p = 0.011 and p < 0.001, respectively). The QoL scores for physical domains were higher in the LAT group at 1 and 3 months post-surgery (p < 0.01). No significant differences were observed in the mental health domains between groups.

Conclusions: LAT for multivessel OPCAB is associated with reduced postoperative pain, shorter hospital stay, and improved early QoL, particularly in physical domains, compared to MS. These findings suggest that LAT is a preferable option for suitable patients, promoting faster recovery and better early postoperative outcomes.