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Title: Clinical outcome, pain perception and activities of daily life after minimally invasive coronary artery bypass grafting
Authors: Uymaz, Barış
Sezer, Gül
Coşkun, Pınar Köksal
Tarcan, Onurcan
Özleme, Seyhan
Aybek, Tayfun
Keywords: minimally invasive coronary revascularization
partial lower sternotomy
survival analysis
Issue Date: 2014
Publisher: Turkish Soc Cardiology
Abstract: Objective: Minimally invasive direct coronary artery bypass (MIDCAB) for revascularization of the left anterior descending artery has become a routine operation. We present our clinical experiences with beating heart MIDCAB surgery performed through partial lower sternotomy (PLS) and retrospectively compare the results of pain perception as well as activities of daily life (ADL) with the conventional full sternotomy. Methods: From January 2009 to August 2012, 197 patients underwent MIDCAB using modified PLS at our hospital. Their mean age was 58.5Methods: From January 2009 to August 2012, 197 patients underwent MIDCAB using modified PLS at our hospital. Their mean age was 585 +/- 10.5 years. 54 (28%) had previous myocardial infarction, 38 (19%) had diabetes mellitus. The visual analog scale (VAS) for pain one, two and three, the ADL score for mobilization were obtained within four days after surgery. 98% of patients were followed-up with both direct visits and questionnaires to assess the major adverse cardiac events (MACE). We performed t-test for comperative data and Kaplan-Meier curves for survival analysis. Results: There was one postoperative death (0.5%) and three conversions to full sternotomy (1.5%). Postoperative angiography was performed in 34 (17.2%) patients, who had some symptoms during the follow-up period of 45 months. The graft patency rate was 96.5% (190 of 197). At follow-up (24.1 +/- 11.7 months), survival free of MACE was 91.8 +/- 3.1% at 3.5 years. Both the Visual Analog Scale (VAS 35.1 +/- 9.6 vs. 57.1 +/- 7.8) and the ADL score (80.4 +/- 11.8 vs. 36.2 +/- 8.6) were significantly higher after the operation in comparison to the matched group of beating heart revascularizations with full sternotomy (p<0.001). Conclusion: This study demonstrates that the MIDCAB using PLS can achieve an effective intermediate-term revascularization and an acceptable clinical outcome. Patients who undergo this procedure are free of major complications and enjoy good quality of life after surgery.
ISSN: 2149-2263
Appears in Collections:Cerrahi Tıp Bilimleri Bölümü / Department of Surgical Sciences
PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
TR Dizin İndeksli Yayınlar / TR Dizin Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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