Minimally Invasive Coronary Artery Bypass Grafting for Multivessel Coronary Artery Disease: A Systematic Review.

Davorin Sef, Myat Soe Thet, Shahrul Amry Hashim, Keita Kikuchi
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Abstract

Objective: We conducted a systematic review of all available evidence on the feasibility and safety of minimally invasive coronary artery bypass grafting (MICS CABG) in patients with multivessel coronary artery disease (CAD).

Methods: A systematic literature search in PubMed, MEDLINE via Ovid, Embase, Scopus, and Web of Science was performed to identify all relevant studies evaluating outcomes of MICS CABG among patients with multivessel CAD and including at least 15 patients with no restriction on the publication date.

Results: A total of 881 studies were identified, of which 26 studies met the eligibility criteria. The studies included a total of 7,556 patients. The average patient age was 63.3 years (range 49.5 to 69.0 years), male patients were an average of 77.8% (54.0% to 89.8%), and body mass index was 29.8 kg/m2 (24.5 to 30.1 kg/m2). Early mortality and stroke were on average 0.6% (range 0% to 2.0%) and 0.4% (range 0% to 1.3%), respectively. The average number of grafts was 2.8 (range 2.1 to 3.7). The average length of hospital stay was 5.6 days (range 3.1 to 9.3 days).

Conclusions: MICS CABG appears to be a safe method in well-selected patients with multivessel CAD. This approach is concentrated at dedicated centers, and there is no widespread application, although it has potential to be widely applicable as an alternative for surgical revascularization. However, large randomized controlled studies with longer follow-up are still required to compare the outcomes with conventional CABG and other revascularization strategies.

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微创冠状动脉旁路移植术治疗多支血管冠状动脉疾病:系统回顾。
目的:我们对多支冠状动脉疾病(CAD)患者微创冠状动脉旁路移植术(MICS CABG)的可行性和安全性的所有可用证据进行了系统性回顾:在 PubMed、MEDLINE via Ovid、Embase、Scopus 和 Web of Science 中进行了系统性文献检索,以确定所有评估多支血管 CAD 患者微创冠状动脉旁路移植术(MICS CABG)疗效的相关研究,研究对象至少包括 15 名患者,发表日期不限:结果:共确定了 881 项研究,其中 26 项研究符合资格标准。这些研究共纳入了 7556 名患者。患者平均年龄为 63.3 岁(49.5 至 69.0 岁),男性患者平均占 77.8%(54.0% 至 89.8%),体重指数为 29.8 kg/m2(24.5 至 30.1 kg/m2)。早期死亡率和中风率平均分别为 0.6%(0% 至 2.0%)和 0.4%(0% 至 1.3%)。移植物的平均数量为 2.8(范围为 2.1 至 3.7)。平均住院时间为5.6天(3.1至9.3天不等):结论:对于经过严格筛选的多支血管 CAD 患者,MICS CABG 似乎是一种安全的方法。这种方法主要集中在专门的中心,目前还没有广泛应用,尽管它有可能作为外科血运重建的替代方法广泛应用。不过,还需要进行更长时间的大型随机对照研究,以比较与传统 CABG 和其他血管再通策略的效果。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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