当科におけるＭＩＤＣＡＢ連続６５例の手術成績

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  • Clinical Result of Consecutive 65 Cases of Minimally Invasive Direct Coronary Artery Bypass Grafting

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Minimally invasive direct coronary artery bypass grafting (MIDCAB) has been performed in some institutions and mid-term results have been reported. However, because of its technical difficulty, the procedure has not been gaining acceptance among cardiovascular surgeons. We report the clinical results of our MIDCAB series and describe the effect and role of the MIDCAB in the therapy of ischemic heart disease. From May 1999 through May 2002, 65 patients (age 29 to 90 years) underwent MIDCAB via a small left thoracotomy. Postoperative angiography was performed before discharge in all patients. No conversions to sternotomy were necessary. There were no operative, hospital or mid-term mortalities, nor were these any major complications, including myocardial infarction, stroke, respiratory failure, and other organ failure. Wound infection occurred in 1 patient. No graft occlusion was seen. Graft stenosis was seen in only 1 patient. The graft patency rate was 98.5% (66/67). Postoperative cardiac events included 2 incidents of angina, and 4 of atrial fibrillation. There were no incidents of congestive heart failure. MIDCAB is a safe and less-invasive operation. According to our clinical results, MIDCAB is an alternative to conventional coronary artery bypass grafting for selected patients, especially for those at high risk.

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