Minimally Invasive Bypass Procedure Produces Excellent Results

Excellent clinical results can be achieved with the new minimally invasive coronary artery bypass technique, a study has found.

As suggested in this study, the early clinical adverse event rate is likely to decrease over time with increasing experience in performing this new surgical technique, the authors note.

In the new procedure, the left internal mammary artery is anastomosed under direct visualization to the left anterior descending artery without cardiopulmonary bypass.

Researchers in New York City and Washington conducted minimally invasive coronary artery bypass (MIDCAB) on 274 heart patients from the time the procedure was introduced at one single centre.

Both in-hospital and one-year clinical cardiac events were source-documented and adjudicated by the researchers.

The in-hospital major acute cardiac event rate was found to be 2.2 percent; this included a 1.1 percent mortality rate. At one year, the major acute cardiac event rate was 7.8 percent, which included a 2.5 percent mortality.

When compared with the first 100 procedures, however, the subsequent 174 procedures produced shorter vessel occlusion times, times to extubation and lengths of hospital stay. Furthermore, cumulative one-year adverse cardiac events were 11 percent in the initial 100 cases and six percent in the following 174 cases.

The authors concluded that clinical results of the MIDCAB technique are excellent and the clinical adverse event rate may decrease with accumulated experience.