[The early results of the minimally invasive direct coronary artery bypass (MIDCAB)].

The clinical experiences of 29 consecutive MIDCAB procedures performed at our institution between October, 1996, and October, 1997, were analyzed. Preoperative patient's characteristics were as follows; LAD single vessel disease: 25, double vessel disease: 1, triple vessel disease: 1, RC single vessel disease: 1, LMT lesion: 1, concomitant procedures: 2 (ASO: 1, AAA: 1). LITA harvesting was performed using the video-assisted thoracoscopy in initial 4 patients, and in last 10 patients we used the specially designed retractor THORALIFT (Autosuture Co., Ltd.) for harvesting LITA by direct vision. LAD was stabilized mechanically using the stabilizer when we performed the anastomosis in last 10 patients to enhance the quality of the anastomosis. The patency rate was 96%, but there were two patients (6%) who had the stenosis of the anastomosis site. Coronary artery occlusion time was 13.2 minutes in the mean. We also studied the hemodynamics of blood flow in LITA grafts with the aid of 7.5 MHz transthoracic duplex imaging in these MIDCAB patients and compared with the LITA grafts in conventional CABG performed in same periods. There were no statistical differences between the two groups about the graft flow and velocity. We conclude that MIDCAB would be an alternative procedure that can be performed with low risk and acceptable early results in selected patients.