The comparison between minimally invasive coronary bypass grafting surgery and conventional bypass grafting surgery in proximal LAD lesion

Purpose: Minimally invasive bypass grafting surgery has entered the clincal routine in several centers of the world, with an increasing popularity in the last decade. Nowadays, applications of the operations on beating heart has gained importance due to the advances in technical level and recently it is commonly used with the developed minimally invasive techniques. In our study, we aimed to make a comparison between minimally invasive coronary artery bypass grafting surgery and conventional bypass grafting surgery in isolated proximal LAD lesions. Study Plan: In our center between January 2004 and December 2011, patients with proximal LAD lesion, which are treated with robot assisted minimally invasive coronary artery bypass surgery or conventional bypass surgery, were included in the study. In group 1, coronary bypass with cardiopulmonary bypass and complete sternotomy was applied to 35 patients and in group 2, robot assisted minimally invasive bypass surgery was applied to 35 patients. The demographic, preoperative, perioperative and postoperative data are gathered retrospectively. Results: The mean follow up time of conventional bypass group was 5,7±1,7 years, this value was 7,3 ±1,3 in robotic group. There were not complications like postoperative TIA, wound infection, mortality, or need for IABP in any of the patients. In conventional bypass group the transfusion average and ventilation time were significantly higher (p<0,05). The ICU stay and hospital stay were significantly shorter in the cases of the robotic group (p<0,01). The postoperative pneumonia rate was significantly higher (20%) in the conventional bypass group (p<0,01). Postoperative 1st day pain score average was higher in robotic group (p<0,05). Postoperative 3rd day pain score average in the conventional bypass group was higher (p<0,05). Graft patency rate was found 88,6% in conventional bypass group, this ratio was 91,4% robotic bypass group, which did not resulted in any significance (p>0,05). Conclusion: In isolated proximal LAD stenosis, robotic assisted minimally invasive coronary artery bypass grafting surgery requires less blood products, is associated with shorter ICU and hospital stay and lesser pain in the early postoperative period in contrast to conventional surgery. Our results which showed similarities with contemporary literature lead us to the idea of future importance and common usage of minimally invasive interventions.