NDLI: Minimally invasive direct coronary artery bypass versus single internal thoracic artery grafting procedures for multivessel coronary artery disease: a single-center retrospective analysis

Content Provider	Springer Nature : BioMed Central
Author	Kakoush, Mohammad Gordon, Amit Farkash, Ariel Teich, Nadav Sela, Orr Pevni, Dmitri Ziv-Baran, Tomer Kfir, Jonathan Ben-Gal, Yanai
Abstract	Objective To compare two surgical strategies for myocardial revascularization: one by a minimally invasive direct coronary artery bypass (MIDCAB) and the other by a conventional full sternotomy coronary artery bypass grafting (CABG). Methods We reviewed the early outcomes and overall survival of all the patients treated in our center by the above strategies during 2000–2011. Results Of 1915 patients, 1752 underwent conventional CABG utilizing a single internal thoracic artery (ITA) graft and 163 underwent a MIDCAB procedure. In the former compared to the latter, the patients were older and the median EuroSCORE was higher. The prevalences were higher of diabetes mellitus, recent myocardial infarction, emergency procedures, the.usage of an intra-aortic balloon pump, redo operations, and peripheral vascular disease; and the prevalences lower of chronic obstructive pulmonary disease and chronic renal failure. The median follow-up was 20 years. Early mortality (30 day) was greater in the conventional CABG group (3.6% vs. 0.6%, p = 0.042); and 10-, 15- and 20-year survival rates were lower: 55.1% vs. 76.7%, 37.1% vs. 63.7%, and 23.1% vs. 53.4%, respectively, p < 0.001. In an analysis that compared two matched groups of 134 patients each, early outcomes were similar, but late survival was lower following conventional CABG compared to MIDCAB after 10, 15 and 20 years: 64.7% vs. 74.6%, 44.7% vs. 64.1%, and 28.4% vs. 53.6% respectively, p = 0.004. In multivariable and univariate analysis, MIDCAB strategy compared to conventional single ITA CABG was associated with better late survival; the hazard ratio was 0.429 (95%CI 0.321–0.574, p < 0.001) for the whole cohort and 0.559 (95%CI: 0.376–0.831, p = 0.004), for the matched cohort. Conclusions Compared to conventional CABG utilizing a single ITA, the MIDCAB procedure demonstrated early safety and long-term effectiveness for surgical myocardial revascularization of the left anterior descending artery.
Related Links	https://cardiothoracicsurgery.biomedcentral.com/counter/pdf/10.1186/s13019-025-03410-0.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	17498090
DOI	10.1186/s13019-025-03410-0
Journal	Journal of Cardiothoracic Surgery
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2025-04-11
Access Restriction	Open
Subject Keyword	Cardiac Surgery Thoracic Surgery
Content Type	Text
Resource Type	Article
Subject	Surgery Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine
Journal Impact Factor	1.5/2023
5-Year Journal Impact Factor	1.6/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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