Universität zu Köln

Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Patil, Nikhil P., Weymann, Alexander, Mohite, Prashant N., Zych, Bartlomiej, Saez, Diana Garcia, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004, Wahlers, Thorsten, Wittwer, Thorsten, Wippermann, Jens, Amrani, Mohamed, Trimlett, Richard, Simon, Andre R., Pepper, John and Bahrami, Toufan (2014). Outcomes after different non-sternotomy approaches to left single-vessel revascularization: a comparative study with up to 10-year follow-up. Eur. J. Cardio-Thorac. Surg., 46 (4). S. E48 - 8. CARY: OXFORD UNIV PRESS INC. ISSN 1873-734X

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Abstract

OBJECTIVES: Various non-sternotomy approaches have been used for left internal mammary artery (LIMA) grafting in left single-vessel revascularization. The aim of this study was to evaluate the impact of three different non-sternotomy techniques on long-term outcomes after left single-vessel revascularization. METHODS: A total of 502 patients having single-vessel LAD disease treated from April 2003 to May 2013 by minimally invasive direct coronary artery bypass grafting (MIDCAB), endoscopically assisted coronary artery bypass grafting (EACAB) or robotically assisted direct coronary artery bypass grafting (RADCAB) were reviewed. In all cases, distal anastomoses were performed through anterolateral minithoracotomy incisions. In-hospital and long-term (10-year) outcomes were compared using standard and propensity score-adjusted analyses. RESULTS: One hundred and eighty-nine patients had MIDCAB, 76 had EACAB and 236 had RADCAB. After propensity score matching, RADCAB patients had significantly longer operative duration (P < 0.001), whereas MIDCAB and RADCAB patients had significantly higher incidence of postoperative angina over the follow-up (P = 0.034). The groups were comparable regarding in-hospital mortality and reintervention rate as well as incidence of myocardial infarction, reoperations, reinterventions and cardiac death. All groups showed comparable long-term survival (P = 0.943). CONCLUSIONS: MIDCAB, EACAB and RADCAB are associated with similar long-term survival and incidence of major adverse cardiac events (MACEs) in single-vessel surgical revascularization. However, the endoscopic approach was found to be free from the disadvantages of longer operating duration observed in RADCAB or higher incidence of angina and shorter freedom from MACEs observed in both MIDCAB and RADCAB groups.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Patil, Nikhil P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohite, Prashant N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zych, Bartlomiej UNSPECIFIED UNSPECIFIED UNSPECIFIED Saez, Diana Garcia UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittwer, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Amrani, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Trimlett, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Andre R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pepper, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahrami, Toufan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-426383
DOI:	10.1093/ejcts/ezu287
Journal or Publication Title:	Eur. J. Cardio-Thorac. Surg.
Volume:	46
Number:	4
Page Range:	S. E48 - 8
Date:	2014
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1873-734X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CORONARY-ARTERY-BYPASS; ANTERIOR DESCENDING ARTERY; DRUG-ELUTING STENTS; OFF-PUMP; SURGERY Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42638