A summary of 161 cases of coronary artery surgery through left anterior lateral chest mini-incision

Liu Shuo; You Bin; Chen Changcheng; Xu Yi; Li Ping; Xu Lili; Li Guang; Qu Zheng; Zhang Jingwei

doi:10.3760/j.issn.1673-4777.2018.08.008

Abstract：Objective To investigate the feasibility and efficacy of minimally invasive coronary artery surgery with left anterior lateral tboracotomy.Methords Clinical records of 161 cases of coronary artery surgery through left anterior lateral chest mini-incision from July 2010 to February 2018 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed (2 cases of right internal mammary artery-right coronary artery bypass had right chest incision).There were 122 males and 39 females;the mean age was (60 ± 10)years old;the mean body mass was (72 ± 8)kg.Surgical methods included 116 cases of one-branch coronary bypass (70 cases of single coronary lesion,38 cases of hybrid coronary surgery,4 cases of Davinci robot assisted coronary bypass,3 cases of anterior descending muscle bridge and 1 case of Kawasaki disease),33 cases of two-branch coronary bypass,2 cases of three-branch coronary bypass,3 cases of myocardial bridge lysis,3 cases of coronary fistula ligation and 4 cases of one-stop hybrid coronary revascularization.Results There were 2 deaths(1.2％),including 1 case of one-stop hybrid coronary revascularization and 1 case of two-branch coronary bypass;159 patients had successful surgery and recovered well.Operation time was (4.0 ± 1.3) h,2-7 h.Postoperative 1 d drainage volume was (354 ±318)ml,10-1 380 ml.Mechanical ventilation time was (14 ±7)h,5-38 h.Blood transfusion rate was 20.6％ (n =33).Postoperative hospitalization time was (6.0 ± 1.8) d,4-11 d.Left ventricular end-diastolic diameter after operation showed no significant difference compared to that before operation [(48 ± 6)mm vs (49 ±5) mm] (P ＞ 0.05).All patients recovered well during follow-up (1 month to 7 years and 6 months).Conclusion Minimally invasive coronary artery surgery through left anterior lateral chest incision is a safe,effective and quick recovery method in treatment of coronary heart disease.