comparison of early outcome between minimal invasive left mini thoracotomy and standard median sternotomy in patients undergoing off-pump isolated coronary artery bypass graft surgery.
Tanvir Rahman, MS, Farooque Ahmed, MS, Prasanta K. Chanda, MS, M A. Gafur, MS, Kamrul Hasan, MS, Kamrul Alam, MS, Hossain A. Mahmud
Background: This study evaluates the feasibility of minimal invasive direct vision left mini thoracotomy for off-pump isolated coronary artery bypass graft surgery.The aim of the study was to compare the short term outcomes for isolated coronary artery bypass graft through conventional standard median sternotomy and direct vision left mini thoracotomy in our settings.
Method:from July 2015 to June 2017,total 22 patients undergone minimal invasive direct vision left mini thoracotomy were taken as case and 22 patients undergone standard median sternotomy were randomly selected as control.All underwent offpump isolated coronary artery bypass graft surgery.
Results:Incision length in minimal invasive thoracotomy was significantly smaller (7.52±1.02 cm) comparing with median sternotomy (21.20±1.72 cm), (p<0.00001).Median postoperative length of stay was 6.05±0.84 days versus 8.73±1.45 days (p<.00001), intensive care unit length of stay was 33.41±1.95 hours versus 43.86±2.93 hours (p<.00001) and duration of endotracheal intubation was 11.77±2.53 hours versus 15.18±4.89 hours, (p=0.005) for left mini-thoracotomy and median sternotomy respectively. Postoperative blood loss was significantly reduced in group-1 (207.50±75.92 ml) when compared with group 2 (369.55±220.81 ml), (p=0.003). Postoperative blood transfusion requirement was also significantly reduced in group-1(363.67±87.55 ml) when compared with group-2 (545±221.67 ml),
(p=0.083).There were no differences in post operative atrial fibrilation,wound infection, post CABG myocardial infarction and 30-days mortality.
Conclusion:Off-pump isolated coronary artery bypass grafting can be performed through a left minithoracotomy under direct vision without compromising the patient’s safety and satisfactory early outcome.
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