aDivision of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada bDepartment of Cardiothoracic Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates cCardiothoracic Department, Staten Island University Hospital, New York, USA.
Curr Opin Cardiol. 2013 Nov;28(6):639-45. doi: 10.1097/HCO.0b013e3283653fd1.
Minimally invasive coronary artery bypass grafting (MICS CABG) consists of single-vessel or multivessel revascularization via a small left thoracotomy, and has been proposed as an alternative to a standard sternotomy approach. The purpose of this article is to examine the current status of MICS CABG and discuss its future directions.
Experience in the first 450 cases was reported in 2009, and established the efficacy and safety of a small thoracotomy approach for multivessel and single-vessel revascularization. In addition to earlier recovery and rehabilitation, MICS CABG is associated with fewer transfusions and fewer wound infections than off-pump CABG. Recently, the MICS CABG Patency Study showed excellent graft patency in patients assessed by 64-slice computed tomography angiography 6 months after operation. We also showed that the use of cardiopulmonary bypass assistance may help alleviate some of the learning curve inherent in this operation.
MICS CABG has developed into a reproducible, high-quality, complete surgical revascularization alternative to conventional CABG. Preservation of sternal integrity allows patients to recover earlier, require fewer transfusions, and experience fewer infections. Further research on expanding the applicability of MICS CABG and enhancing its advantages over conventional CABG is warranted.
微创冠状动脉旁路移植术（MICS CABG）通过小左开胸进行单支或多支血管血运重建，已被提议作为标准胸骨切开术的替代方法。本文的目的是研究 MICS CABG 的现状并探讨其未来方向。
2009 年报道了前 450 例的经验，确立了小开胸术用于多支血管和单支血管血运重建的疗效和安全性。与非体外循环 CABG 相比，MICS CABG 除了更早的恢复和康复外，还与更少的输血和更少的伤口感染相关。最近，MICS CABG 通畅性研究通过 64 层计算机断层血管造影术显示术后 6 个月患者的吻合口通畅性良好。我们还表明，使用体外循环辅助可能有助于减轻该手术固有的一些学习曲线。
MICS CABG 已发展成为一种可重复、高质量的、完整的外科血运重建替代方法，可与传统 CABG 相媲美。保持胸骨完整性可使患者更早恢复，需要更少的输血，并减少感染。进一步研究扩大 MICS CABG 的适用性并增强其优于传统 CABG 的优势是有必要的。
