Left Anterior Mini-Thoracotomy vs. Conventional Sternotomy in On-Pump Multivessel Coronary Revascularization.

Abstract

Objective: In this study, we aimed to compare the outcomes of left anterior mini-thoracotomy and conventional sternotomy in on-pump multivessel coronary revascularization.

Methods: Two hundred sixty-two patients who underwent minimally invasive coronary artery bypass grafting through the left anterior mini-thoracotomy and conventional coronary artery bypass grafting with full sternotomy were included. All patients were divided into two groups - 132 patients who underwent minimally invasive multivessel coronary artery bypass grafting in Group I, and 130 patients with full sternotomy in Group II. Intraoperative variables (cross-clamping time, cardiopulmonary bypass time, etc.), postoperative parameters (drainage amount, revision, intensive care and hospital stay times, etc.), and mortality were analyzed retrospectively.

Results: Cardiopulmonary bypass time (152.24 ± 36.4 minutes) was significantly longer in Group I than in Group II (102.24 ± 19.4 minutes) (P<0.001). Cross-clamping time (86 ± 13.2 minutes) was significantly longer in Group I than in Group II (62 ± 21.4 minutes) (P<0.001). And intensive care stay time (P=0.005) and hospital stay time (P=0.004) were significantly shorter in Group I. In the postoperative period, six patients in Group I and seven patients in Group II were revised due to bleeding. Total perioperative mortality was one patient in both groups (P=0.82).

Conclusion: Multivessel coronary artery bypass grafting through the left anterior mini-thoracotomy is an effective, reliable, and successful method, due to less drainage amount and less blood transfusion need, shorter intensive care and hospital stays, faster return to daily life, and better cosmetic results compared to conventional methods.