[Minithoracotomy myocardial revascularization: results of early angiographic control].

Overview

AIM OF THE STUDY: Minimally invasive direct coronary artery by-pass (MIDCAB) has been proposed as an alternative technical solution in different clinical settings. However, a systematic angiographic study of the results obtained using this new technique has not been published yet. This paper summarizes our preliminary angiographic results with MIDCAB. MATERIALS AND METHODS: From January 1995 to January 1997, 56 patients underwent MIDCAB. All patients were followed up regularly and underwent stress myocardial scintigraphy. A postoperative angiographic control was performed in 48 patients (87.2% of the total) at a mean postoperative interval of 1.7 +/- 2 months. RESULTS: One patient died in hospital. Five patients required further surgery using conventional techniques (either surgical or percutaneous). In 41/48 patients (85.4%), the mammary artery graft and the left anterior descending artery (LAD) were normal. In two cases, we found an anastomotic stenosis, in two cases there was a LAD lesion distal to the anastomosis (at the application site of the stay sutures), one case showed an anastomotic stenosis associated with a distal LAD stenosis, one case had a mammary graft occlusion and one case showed a thrombus-like image in the LAD proximal to the anastomosis. CONCLUSION: Systematic angiographic follow-up of MIDCAB patients seems mandatory in order to evaluate the effectiveness of the technical solutions utilized and to optimize various aspects of this new procedure.