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Ann Thorac Surg 1999;68:1502-1505
© 1999 The Society of Thoracic Surgeons


Supplement: Minimally Invasive Cardiac Surgery

The Dresden approach for complete multivessel revascularization

Vassilios Gulielmos, MD, Michael Brandt, Michael Knaut, MD, Romuald Cichon, MD, Florian M. Wagner, MD, Utz Kappert, MD, Stephan Schüler, MD

Cardiovascular Institute, University of Dresden, Dresden, Germany

Address reprint requests to Dr Schüler, Cardiovascular Institute, University Hospital Dresden, Fetscherstrasse 76, D-01307 Dresden, Germany
e-mail: hkz{at}rcs.urz.tu-dresden.de

Presented at Evolving Techniques and Technologies in Minimally Invasive Cardiac Surgery, San Antonio, TX, Jan 22–23, 1999.

Abstract

Background. In a prospective clinical trial, a group of patients receiving less invasive surgical procedure, including minithoracotomy in combination with cardiopulmonary bypass (group 1), was compared to a group of patients receiving conventional bypass surgery (group 2) for the treatment of coronary artery disease.

Methods. Group 1 included 85 patients (71 men, 14 women, aged 39 to 82 years, median 61.1 ± 9.0 years); group 2 included 53 patients (38 men, 15 women, aged 51 to 79 years, median 62.0 ± 6.1 years).

Results. There were no perioperative deaths in the whole series of patients. Time of operation was 256 ± 43 minutes in group 1 and 150.0 ± 53.6 minutes in group 2. Hospitalization was 6.0 ± 1.4 days and intensive care unit stay 1 day for both groups. Back pain assessment on postoperative day 3 showed less pain in group 1. Three-month follow-up revealed ischemia in stress electrocardiogram in 2 patients (2.5%) in group 1 and in 2 patients (4.1%) in group 2. Coronary angiograms confirmed the stress-electrocardiogram findings.

Conclusions. Surgical results are equal for both techniques. Even though time of operation is longer in patients receiving less invasive procedures, intensive care unit stay and hospital stays are the same length. Early postoperative back pain is less in group 1 and combined with faster convalescence.




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