In:
The Heart Surgery Forum, Forum Multimedia Publishing LLC, Vol. 15, No. 2 ( 2012-04-26), p. 61-
Abstract:
〈 p 〉 〈 b 〉 Background and Aim of the Study: 〈 /b 〉 In this study, we review our experience with 1768 minimally invasive direct coronary artery bypass (MIDCAB) operations. The focus is on long-term outcome with more than 10 years of follow-up. 〈 /p 〉 〈 p 〉 〈 b 〉 Methods: 〈 /b 〉 All patients undergoing standard MIDCAB between 1996 and 2009 were included. For all 1768 patients, pre-, intra-, and postoperative data could be completed. Long-term follow-up information about health status, major adverse cardiac and cerebrovascular events (MACCE), and freedom from angina was collected annually via questionnaire or personal contact. Five-year follow-up is available for 1313 patients, and 10-year-follow-up is available for 748 patients. A multivariate Cox regression analysis was performed to determine risk factors for long-term outcome. 〈 /p 〉 〈 p 〉 〈 b 〉 Results: 〈 /b 〉 Mean age was 63.4 � 10.8 years, mean ejection fraction was 60.0% � 14.2%, and perioperative mortality risk calculated by logistic EuroSCORE was 3.8 � 6.2%. In 31 patients (1.75%) intraoperative conversion to sternotomy was necessary. Early postoperative mortality was 0.8% (15 patients); 0.4% (7 patients) had a perioperative stroke. Seven hundred twelve patients received routine postoperative angiogram, showing 95.5% early graft patency. Short-term target vessel reintervention was needed in 59 patients (3.3%) (11 percutaneous transluminal coronary angioplasty (PTCA)/stent, 48 re-operation). Kaplan-Meyer analysis revealed a 5-year survival rate of 88.3% (95% confidence interval [CI], 86.6% to 89.9%) and a 10-year-survival rate of 76.6% (95% CI, 73.5% to 78.7%). The freedom from MACCE and angina after 5 and 10 years was 85.3% (95% CI, 83.5% to 87.1%) and 70.9% (95% CI, 68.1% to 73.7%), respectively. 〈 /p 〉 〈 p 〉 〈 b 〉 Conclusions: 〈 /b 〉 MIDCAB is a safe operation with low postoperative mortality and morbidity. With excellent short-term and long-term results, it is a very good alternative compared to both percutaneous coronary intervention (PCI) and conventional surgery. 〈 /p 〉
Type of Medium:
Online Resource
ISSN:
1522-6662
,
1098-3511
DOI:
10.1532/HSF98.20111141
Language:
Unknown
Publisher:
Forum Multimedia Publishing LLC
Publication Date:
2012
detail.hit.zdb_id:
2069230-4
