Minimally invasive off‐pump anaortic coronary artery bypass (MACAB)

摘要

Abstract Background Minimally invasive direct coronary artery bypass?has enabled coronary artery bypass graft?to compete with the appeal of less invasive percutaneous coronary procedures. Favorable results of coronary artery bypass surgery performed without the use of cardiopulmonary bypass and without touching the aorta (anOPCAB) have enabled the development and use of minimally invasive methods. Methods Between 2016 and 2021, 112 patients underwent multivessel coronary bypass surgery performed using a minimally invasive method through a small thoracotomy in the left chest with off‐pump, anaortic, and all‐arterial grafts (Minimally Invasive Off‐Pump Anaortic Coronary Artery Bypass MACAB). Patient data were collected and retrospectively analyzed. Eight series from the literature using the multivessel mini‐OPCAB and MACAB technique were also evaluated. Results Collectively, from the literature, 2729 patients underwent an average of 2.4 bypasses with an early mortality rate of 0.7 and a stroke rate of 0.16. In our MACAB case series, 112 patients underwent an average of 2.9 bypasses with a mortality rate of 1.8 and a stroke rate of 0. Conclusion MACAB can be performed safely by experienced surgeons and reduces neurological injury and surgical trauma and may be a good alternative for multivessel stenting. Simulation systems are essential for its dissemination, and teams dedicated to coronary surgery—with subspecialty expertise—are necessary to achieve good outcomes.