MIDCAB and OPCAB Results for Isolated Left Anterior Descending Disease: Comparative Analysis

Aim: To compare safety and efficacy of MIDCAB and OPCAB for isolated LAD disease.

Methods: 53 patients were assigned to the MIDCAB group and 54 patients who underwent anterior descending coronary artery bypass grafting were assigned to the OPCAB group. Patients were recruited in the period from 2019 to 2022. Exclusion criteria were as follows: simultaneous surgical treatment of coronary artery disease, brachiocephalic artery disease, myocardium, valvular heart disease, as well as urgent and repeated surgical interventions.

Results: The mean time of surgery was 189.9±77 min in the MIDCAB group vs. 174.9±54.5 min in the OPCAB group (p=0.2467). The intraoperative blood loss was significantly higher in the OPCAB group (348.6±63.7 mL vs. 143.33±34.5 mL, p<0.0001). The mean postoperative mechanical ventilation time (6.5±2.46 hours vs. 5.4±3.1 hours, p=0.0444), the length of stay in the intensive care unit (1.03±0.3 vs. 1.27±0.8 days, P=0.0431) and the length of the in-hospital stay (8.3±2.4 vs. 12.7±5.5 days, p<0.0001) were significantly higher in the OPCAB group. There were no in-hospital deaths in both groups. The need for blood transfusion was higher in the OPCAB group (22.2% in the OPCAB group vs. 5.7% in the MIDCAB group, p=0.0235). Perioperative complications were more common after sternotomy (20.4% in the OPCAB vs. 7.4% in the MIDCAB group, p=0.0926). The 4-year cumulative survival was 96.8% in the MIDCAB group vs. 92.8% in the OPCAB group (p = 0.673). The cumulative freedom from adverse cardiac events was 91.2% in the MIDCAB group vs. 91.9% in the OPCAB group (p=0.421).

Conclusion: MIDCAB is a safe and effective surgical method for treating patients with coronary artery disease ensuring optimal clinical outcomes and improved quality of life. Therefore, MIDCAB should be considered as an optimal treatment strategy for the routine clinical practice.

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