Sicim Hüseyin, Fedakar Ali
Department of Cardiovascular Surgery, Kırklareli Training and Research Hospital, Kırklareli, Turkey.
Department of Cardiovascular Surgery, Hisar Intercontinental Hospital, Istanbul, Turkey.
Braz J Cardiovasc Surg. 2025 May 30;40(3):e20230299. doi: 10.21470/1678-9741-2023-0299.
In this study, we aimed to compare the outcomes of left anterior mini-thoracotomy and conventional sternotomy in on-pump multivessel coronary revascularization.
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.
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).
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.
在本研究中，我们旨在比较在体外循环下进行多支冠状动脉血运重建时左前小切口开胸术与传统胸骨切开术的效果。
纳入262例通过左前小切口开胸术进行微创冠状动脉旁路移植术以及通过传统胸骨正中切开术进行冠状动脉旁路移植术的患者。所有患者分为两组——I组132例行微创多支冠状动脉旁路移植术，II组130例行胸骨正中切开术。回顾性分析术中变量（阻断时间、体外循环时间等）、术后参数（引流量、再次手术、重症监护和住院时间等）以及死亡率。
I组的体外循环时间（152.24±36.4分钟）显著长于II组（102.24±19.4分钟）（P<0.001）。I组的阻断时间（86±13.2分钟）显著长于II组（62±21.4分钟）（P<0.001）。I组的重症监护停留时间（P=0.005）和住院时间（P=0.004）显著更短。术后，I组有6例患者和II组有7例患者因出血进行了再次手术。两组围手术期总死亡率均为1例患者（P=0.82）。
与传统方法相比，通过左前小切口开胸术进行多支冠状动脉旁路移植术是一种有效、可靠且成功的方法，因为其引流量更少、输血需求更少、重症监护和住院时间更短、恢复日常生活更快且美容效果更好。
