[Long-term outcomes of minimally invasive coronary artery bypass grafting].

Objective: To evaluate long-term clinical efficacy of MICS CABG compared to surgery through sternotomy.

Material And Methods: The study included 158 patients who underwent minimally invasive CABG through left-sided mini-thoracotomy between 2017 and 2023. The primary endpoints were in-hospital mortality and 5-year survival, secondary endpoint - freedom from adverse cardiac events. The control group enrolled 150 patients who underwent median sternotomy.

Results: Mean follow-up period was 3.1±1.9 years. There were no differences in 5-year freedom from adverse cardiac events (84.7% versus 81.6%, >0.05). Long-term survival (after 5 years) was 99% and 95%, respectively (>0.05). In our study, the risk rate of wound complications after MICS CABG was 3 times lower compared to surgeries through sternotomy. Naturally, this reduces postoperative hospital-stay, promotes faster recovery and shortens the rehabilitation period. No significant differences in the quality of life after minimally invasive and traditional CABG indicates that MICS CABG does not reduce the effectiveness of myocardial revascularization. Thus, MICS CABG is not only characterized by low surgical risk, but also able to provide stable long-term results.

Conclusion: MICS CABG is a safe and effective surgery. This surgery is not inferior to standard CABG through median sternotomy regarding long-term results, quality of life and life expectancy. However, this approach has advantages in patients with high risk of postoperative sternal wound complications. It also reduces the rehabilitation period and promotes early return to everyday life.