Minimally invasive coronary artery bypass grafting without cardiopulmonary bypass

Massimo A Mariani, Piet W Boonstra, Jan G. Grandjean, Cees van der Schans, Sybren Dusseljee, Ellen van Weert

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

To determine the feasibility and the effectiveness of minimally invasive direct coronary artery bypass without cardiopulmonary bypass (MICABG) in patients with left anterior descending (LAD) coronary artery disease, we evaluated 90 consecutive patients who underwent MICABG at the University Hospital of Groningen.

PATIENTS: Between January 1995 and December 1996, 50 patients (mean age 60 +/- 10.3 years) with documented myocardial ischemia and isolated stenosis of the LAD were selected for MICABG. Patients with any associated cardiac disease or with acute or evolving myocardial infarction were excluded.

METHODS: A small left antero-lateral thoracotomy in the 5th intercostal space was made in all patients, anastomosing the left internal mammary artery (LIMA) to the LAD. A short-term (3 days) postoperative rehabilitation programme was used. Emotional stress (STAY-DY-1 score), wound pain (VAS: visual analogue score) and O2-saturation after a 6 min walking test were measured during hospitalisation and at the first follow-up examination (2.5 week after discharge).

RESULTS: Mean operative time was 92 +/- 25 min (range 60-170). We recorded 1 (1.1%) in-hospital death and three cases (3.3%) of perioperative myocardial infarction. In two cases the MICABG was converted to the midline sternotomy. One patient underwent urgent reoperation on postoperative day 1 via midline sternotomy. Mean hospital stay was 4.4 +/- 2 days. Emotional stress was significantly reduced during and after hospitalisation, compared with the admission day. Wound pain was mild (3.5/10 VAS) on postoperative day 1 and reduced significantly during hospitalisation and at first follow-up examination. O2-saturation after a 6 min walking test had significantly improved at the first follow-up examination.

CONCLUSION: These results indicate that MICABG is feasible and effective in patients with LAD stenosis and leads to a fast psycho-physical recovery.

Original languageEnglish
Pages (from-to)881-887
JournalEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
Volume11
Issue number5
DOIs
Publication statusPublished - May 1997
Externally publishedYes

Keywords

  • cardiopulmonary bypass
  • coronary disease
  • feasibility studies
  • hospital mortality
  • internal mammary-coronary artery anastomosis
  • middle aged
  • morbidity
  • postoperative pain
  • patient selection
  • psychological stress

Cite this

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title = "Minimally invasive coronary artery bypass grafting without cardiopulmonary bypass",
abstract = "To determine the feasibility and the effectiveness of minimally invasive direct coronary artery bypass without cardiopulmonary bypass (MICABG) in patients with left anterior descending (LAD) coronary artery disease, we evaluated 90 consecutive patients who underwent MICABG at the University Hospital of Groningen.PATIENTS: Between January 1995 and December 1996, 50 patients (mean age 60 +/- 10.3 years) with documented myocardial ischemia and isolated stenosis of the LAD were selected for MICABG. Patients with any associated cardiac disease or with acute or evolving myocardial infarction were excluded.METHODS: A small left antero-lateral thoracotomy in the 5th intercostal space was made in all patients, anastomosing the left internal mammary artery (LIMA) to the LAD. A short-term (3 days) postoperative rehabilitation programme was used. Emotional stress (STAY-DY-1 score), wound pain (VAS: visual analogue score) and O2-saturation after a 6 min walking test were measured during hospitalisation and at the first follow-up examination (2.5 week after discharge).RESULTS: Mean operative time was 92 +/- 25 min (range 60-170). We recorded 1 (1.1{\%}) in-hospital death and three cases (3.3{\%}) of perioperative myocardial infarction. In two cases the MICABG was converted to the midline sternotomy. One patient underwent urgent reoperation on postoperative day 1 via midline sternotomy. Mean hospital stay was 4.4 +/- 2 days. Emotional stress was significantly reduced during and after hospitalisation, compared with the admission day. Wound pain was mild (3.5/10 VAS) on postoperative day 1 and reduced significantly during hospitalisation and at first follow-up examination. O2-saturation after a 6 min walking test had significantly improved at the first follow-up examination.CONCLUSION: These results indicate that MICABG is feasible and effective in patients with LAD stenosis and leads to a fast psycho-physical recovery.",
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author = "Mariani, {Massimo A} and Boonstra, {Piet W} and Grandjean, {Jan G.} and {van der Schans}, Cees and Sybren Dusseljee and {van Weert}, Ellen",
year = "1997",
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doi = "10.1016/S1010-7940(97)01201-3",
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Minimally invasive coronary artery bypass grafting without cardiopulmonary bypass. / Mariani, Massimo A; Boonstra, Piet W; Grandjean, Jan G.; van der Schans, Cees; Dusseljee, Sybren; van Weert, Ellen.

In: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, Vol. 11, No. 5, 05.1997, p. 881-887.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Minimally invasive coronary artery bypass grafting without cardiopulmonary bypass

AU - Mariani, Massimo A

AU - Boonstra, Piet W

AU - Grandjean, Jan G.

AU - van der Schans, Cees

AU - Dusseljee, Sybren

AU - van Weert, Ellen

PY - 1997/5

Y1 - 1997/5

N2 - To determine the feasibility and the effectiveness of minimally invasive direct coronary artery bypass without cardiopulmonary bypass (MICABG) in patients with left anterior descending (LAD) coronary artery disease, we evaluated 90 consecutive patients who underwent MICABG at the University Hospital of Groningen.PATIENTS: Between January 1995 and December 1996, 50 patients (mean age 60 +/- 10.3 years) with documented myocardial ischemia and isolated stenosis of the LAD were selected for MICABG. Patients with any associated cardiac disease or with acute or evolving myocardial infarction were excluded.METHODS: A small left antero-lateral thoracotomy in the 5th intercostal space was made in all patients, anastomosing the left internal mammary artery (LIMA) to the LAD. A short-term (3 days) postoperative rehabilitation programme was used. Emotional stress (STAY-DY-1 score), wound pain (VAS: visual analogue score) and O2-saturation after a 6 min walking test were measured during hospitalisation and at the first follow-up examination (2.5 week after discharge).RESULTS: Mean operative time was 92 +/- 25 min (range 60-170). We recorded 1 (1.1%) in-hospital death and three cases (3.3%) of perioperative myocardial infarction. In two cases the MICABG was converted to the midline sternotomy. One patient underwent urgent reoperation on postoperative day 1 via midline sternotomy. Mean hospital stay was 4.4 +/- 2 days. Emotional stress was significantly reduced during and after hospitalisation, compared with the admission day. Wound pain was mild (3.5/10 VAS) on postoperative day 1 and reduced significantly during hospitalisation and at first follow-up examination. O2-saturation after a 6 min walking test had significantly improved at the first follow-up examination.CONCLUSION: These results indicate that MICABG is feasible and effective in patients with LAD stenosis and leads to a fast psycho-physical recovery.

AB - To determine the feasibility and the effectiveness of minimally invasive direct coronary artery bypass without cardiopulmonary bypass (MICABG) in patients with left anterior descending (LAD) coronary artery disease, we evaluated 90 consecutive patients who underwent MICABG at the University Hospital of Groningen.PATIENTS: Between January 1995 and December 1996, 50 patients (mean age 60 +/- 10.3 years) with documented myocardial ischemia and isolated stenosis of the LAD were selected for MICABG. Patients with any associated cardiac disease or with acute or evolving myocardial infarction were excluded.METHODS: A small left antero-lateral thoracotomy in the 5th intercostal space was made in all patients, anastomosing the left internal mammary artery (LIMA) to the LAD. A short-term (3 days) postoperative rehabilitation programme was used. Emotional stress (STAY-DY-1 score), wound pain (VAS: visual analogue score) and O2-saturation after a 6 min walking test were measured during hospitalisation and at the first follow-up examination (2.5 week after discharge).RESULTS: Mean operative time was 92 +/- 25 min (range 60-170). We recorded 1 (1.1%) in-hospital death and three cases (3.3%) of perioperative myocardial infarction. In two cases the MICABG was converted to the midline sternotomy. One patient underwent urgent reoperation on postoperative day 1 via midline sternotomy. Mean hospital stay was 4.4 +/- 2 days. Emotional stress was significantly reduced during and after hospitalisation, compared with the admission day. Wound pain was mild (3.5/10 VAS) on postoperative day 1 and reduced significantly during hospitalisation and at first follow-up examination. O2-saturation after a 6 min walking test had significantly improved at the first follow-up examination.CONCLUSION: These results indicate that MICABG is feasible and effective in patients with LAD stenosis and leads to a fast psycho-physical recovery.

KW - cardiopulmonary bypass

KW - coronary disease

KW - feasibility studies

KW - hospital mortality

KW - internal mammary-coronary artery anastomosis

KW - middle aged

KW - morbidity

KW - postoperative pain

KW - patient selection

KW - psychological stress

KW - cardiopulmonary bypass

KW - coronaire ziekte

KW - haalbaarheidsonderzoek

KW - vrouwelijk

KW - follow-up studies

KW - ziekenhuismortaliteit

KW - mensen

KW - internal mammary-coronary artery anastomosis

KW - verblijfsduur

KW - mannelijk

KW - middelbaar

KW - minimaal invasieve chirurgische ingreep

KW - morbiditeit

KW - pijn, post-operatief

KW - patientselectie

KW - postoperatieve complicaties

KW - retrospectieve studies

KW - stress, psychologisch

KW - tijdsfactoren

KW - tijdschrifartikel

U2 - 10.1016/S1010-7940(97)01201-3

DO - 10.1016/S1010-7940(97)01201-3

M3 - Article

VL - 11

SP - 881

EP - 887

JO - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

SN - 1010-7940

IS - 5

ER -