Early and follow-up angiography in minimally invasive coronary bypass without mechanical stabilization.

Abstract

This study was undertaken to assess the early and late outcome of coronary anastomosis constructed on a beating heart without the help of mechanical stabilization. All consecutive patients (51) from January 1996 to September 1997 who had bypass done by one surgeon using a left minithoracotomy (39) or median sternotomy (12) on a beating heart with occlusive local snares without mechanical stabilization underwent follow-up angiography early (100%) (within 6 hours) and late (63.5%) at a mean of 9.6+/-4.48 months (range, 3.3 to 19.1 months). The cumulative late patency was 95.4% (83 of 87 patients), with two early and two late occlusions. There was no early or late mortality or perioperative myocardial infarction. Two patients (3.9%) developed recurrent angina. Four anastomotic irregularities (4 of 32 patients, 12.6%) have cleared up on follow-up angiography. There was no evidence of late stenosis at the snare sites used for local occlusion. Minimally invasive coronary bypass is safe and effective. Early angiographic abnormalities should be interpreted with caution and we could not demonstrate any long-term deleterious effects of local snaring.