Emrecan Bilgin, Ozdemir Ahmet Coşkun
Department of Cardiovascular Surgery, Pamukkale University, Denizli, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2013 Mar;8(1):74-9. doi: 10.5114/wiitm.2011.30945. Epub 2012 Oct 8.
Minimally invasive direct coronary artery bypass grafting (MIDCAB) offers arterial revascularization of the left anterior descending (LAD) coronary artery especially in lesions unsuitable for percutaneous coronary interventions. By avoidance of sternotomy and cardiopulmonary bypass its invasiveness is less than that of conventional bypass surgery.
We in this study discuss our surgical experience in the MIDCAB procedure.
Thirteen patients were operated on with the MIDCAB procedure. The inclusion criteria for MIDCAB were pure LAD disease totally occluded or severely stenotic. Patient demographics and preoperative and postoperative data were analyzed.
Mean age of the patients was 60.0 ±8.6 years. Patients' preoperative and postoperative levels of cardiac CK-MB (creatine kinase MB) were not significantly different (p = 0.993). However, cardiac troponin I (p < 0.001), hemoglobin (p < 0.001) and hematocrit (p < 0.001) were significantly different. No perioperative myocardial infarctions or cerebrovascular accidents were seen. The patients were discharged at a mean day of 4.77 with oral antiaggregant therapy. No mortality was seen in the study population.
Minimally invasive direct coronary artery bypass is associated with few perioperative complications. Minimally invasive direct coronary artery bypass in our experience is a very good option for single vessel LAD disease.
微创直接冠状动脉旁路移植术（MIDCAB）可为左前降支（LAD）冠状动脉提供动脉血运重建，尤其适用于不适合经皮冠状动脉介入治疗的病变。通过避免开胸和体外循环，其侵入性小于传统旁路手术。
我们在本研究中讨论了我们在MIDCAB手术中的经验。
13例患者接受了MIDCAB手术。MIDCAB的纳入标准为单纯LAD疾病，完全闭塞或严重狭窄。分析了患者的人口统计学数据以及术前和术后数据。
患者的平均年龄为60.0±8.6岁。患者术前和术后的心肌肌酸激酶同工酶（CK-MB）水平无显著差异（p = 0.993）。然而，心肌肌钙蛋白I（p < 0.001）、血红蛋白（p < 0.001）和血细胞比容（p < 0.001）有显著差异。未观察到围手术期心肌梗死或脑血管意外。患者在平均第4.77天出院，接受口服抗血小板治疗。研究人群中无死亡病例。
微创直接冠状动脉旁路移植术围手术期并发症较少。根据我们的经验，微创直接冠状动脉旁路移植术是单支LAD疾病的一个非常好的选择。
