Comparative characteristics of minimally invasive and classical (median sternotomy) methods of coronary artery bypass grafting

Objective. To analyze the results and comparative characteristics of minimally invasive and classical coronary artery bypass grafting in multivessel coronary artery disease and the presence of critical stenosis. Materials and Methods. Over the past two years, the National Scientific Center of Surgery and Transplantation named after O. O. Shalimov performed mini­invasive coronary artery bypass grafting for multivessel lesions of the coronary arteries in 27 patients (group 1). The comparative study also included 27 patients operated on using the classical method (group 2). The average age of patients was (53.1 ± 3.9) years. There were 46 men (85.2%) and 8 women (14.8%). According to the main indicators, including the number of affected coronary arteries, age, physiological parameters, etc., the groups did not differ statistically significantly. The main methods of the study were coronary angiography, multislice computed tomography of the coronary arteries with 3D reconstruction of the architecture of the great vessels, chest and heart. Results. During the follow­up of patients in both groups for up to a year after the operation, no clinical manifestations of angina and heart failure were noted, which gives reason to state the good function of the shunts. Intra­ and postoperative complications in group 1 occurred in 2 patients: the need for conversion due to cardiac rhythm and hemodynamics (1) and repeated thoracotomy due to bleeding from the arterial shunt (1). In group 2, complications also occurred in 2 patients: sternal diastasis requiring sternoplasty (1) and surgical wound exudation requiring the installation of a vacuum device for 4 days with subsequent secondary suturing (1). Conclusions. Minimally invasive coronary artery bypass grafting is a safe method of myocardial revascularization in multivessel coronary artery disease and critical stenosis. The technique allows for rapid rehabilitation and shorter hospital stays, which is economically beneficial for the hospital. Minimally invasive coronary artery bypass grafting can be considered as an alternative to the classical method of coronary artery bypass grafting with midline sternotomy.