Minimally invasive direct coronary artery bypass.

BACKGROUND: Minimally invasive cardiac surgery is a new and promising approach to the treatment of coronary artery disease allowing surgery to be performed through smaller incisions with lesser morbidity. METHODOLOGY: From November 1995 to February 1997, ten minimally invasive direct coronary artery bypass (MIDCAB) grafts were performed. The left internal mammary artery was used to bypass the left anterior descending coronary artery (LAD) through a limited left anterior thoracotomy. PATIENTS: There were seven males and three females and their ages ranged from 42 to 72 years (mean = 60 years). Two patients had prior interventional procedures. Cardiopulmonary bypass was used in the first two patients. Two patients were converted to conventional surgery early in the series. RESULTS: There was no mortality nor major morbidity. Mean post-operative hospital stay was seven days. To date, three patients have had post-operative angiography confirming the patency of the left internal mammary artery to LAD anastomosis. CONCLUSION: Early results of the MIDCAB procedure are encouraging. However, the definitive place of such procedures awaits longer term follow-up.