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Graft patency and completeness of revascularization in minimally invasive multivessel coronary artery bypass surgery
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  • Lufeng Zhang,
  • Yuanhao Fu,
  • Yicheng Gong,
  • Hong Zhao,
  • Song WU,
  • Hang Yang,
  • Zhe Zhang,
  • Yunpeng Ling
Lufeng Zhang
Peking University Third Hospital
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Yuanhao Fu
Peking University Third Hospital
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Yicheng Gong
Peking University Third Hospital
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Hong Zhao
Peking University Third Hospital
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Song WU
Peking University Third Hospital
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Hang Yang
Peking University Third Hospital
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Zhe Zhang
Peking University Third Hospital
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Yunpeng Ling
Peking University Third Hospital
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Peer review status:UNDER REVIEW

06 Jul 2020Submitted to Journal of Cardiac Surgery
06 Jul 2020Submission Checks Completed
06 Jul 2020Assigned to Editor
06 Jul 2020Reviewer(s) Assigned
22 Jul 2020Review(s) Completed, Editorial Evaluation Pending
27 Jul 2020Editorial Decision: Revise Major
29 Jul 20201st Revision Received
29 Jul 2020Submission Checks Completed
29 Jul 2020Assigned to Editor
01 Aug 2020Reviewer(s) Assigned

Abstract

Objectives: Graft patency and completeness of revascularization were analyzed in patients who underwent off-pump minimally invasive coronary artery bypass grafting via left small thoracotomy. Methods: We retrospectively reviewed the invasive angiography findings and clinical data of 186 consecutive patients who underwent off-pump minimally invasive coronary artery bypass grafting via left small thoracotomy. The left internal thoracic artery and saphenous vein were used to bypass two or more of three coronary artery systems: the left anterior descending artery, left circumflex artery, or right coronary artery. Before hospital discharge, invasive angiography was performed to assess graft patency and completeness of revascularization. Clinical variables during hospitalization and follow-up were collected and analyzed. Results: All 186 patients successfully underwent off-pump minimally invasive coronary artery bypass grafting without conversion to sternotomy or assistance of cardiopulmonary bypass. The mean graft number was 2.81 per patient (range, 2–5), and the total number of grafts was 522. The in-hospital mortality rate was 1.6% (3/186). A total of 181 of 186 (97.3%) patients underwent postoperative invasive angiography. Among the 510 grafts assessed by angiography, the total graft patency rate was 96.3% (491/510) [98.3% (171/174) for left internal thoracic artery grafts and 95.2% (318/334) for saphenous vein grafts]. The rate of complete revascularization was 98.8% (510/516) of the total grafts in 180 of 186 (96.8%) patients. Conclusions: Minimally invasive coronary artery bypass grafting using left internal thoracic artery and saphenous vein grafts provides acceptable graft patency and completeness of revascularization for patients with multivessel disease.