Minimally-Invasive Coronary Artery Bypass Grafting Surgery in a Low-Risk Asian Cohort: a Propensity-Score Matched Study

Abstract

Introduction: Minimally-invasive coronary artery bypass grafting surgery (MICS CABG) offers a new paradigm in coronary revascularisation. This study aims to compare the outcomes of MICS CABG with conventional median sternotomy (MS CABG) within a growing minimally invasive cardiac surgical programme in Singapore. Methods: Propensity matching produced 111 patient pairs who underwent MICS CABG or MS CABG between January 2009 and February 2020 at the National University Heart Centre, Singapore. Minimally invasive direct coronary artery bypass (MIDCAB) patients were matched to single- or double-graft MS CABG patients (Group 1). Multivessel MICS patients were matched to MS CABG patients with equal number of grafts (Group 2). Results: Overall, MICS patients experienced shorter postoperative length of stay (p<0.071). In Group 2, procedural duration (p<0.001) was longer among MICS patients but did not translate to adverse postoperative events. Postoperative outcomes including 30-day mortality, reopening for bleeding, new onset atrial fibrillation as well as neurological, pulmonary, renal and infectious complications were comparable between MICS and MS groups. Conclusion: MICS CABG is a safe and effective approach for surgical revascularisation of coronary artery disease, and trends toward a reduction in hospital stay.