Cureus. 2026 Sep 16;18(9):e116351. doi: 10.7759/cureus.116351. eCollection 2026 Sep.
ABSTRACT
Background Minimally invasive coronary artery bypass grafting (MICS-CABG) through an anterolateral mini-thoracotomy is an alternative to conventional coronary artery bypass grafting through median sternotomy. However, evidence regarding its early clinical outcomes and institutional learning phase remains limited in developing healthcare systems. Objectives To compare the baseline clinical characteristics, intraoperative parameters, and early postoperative outcomes of patients undergoing MICS-CABG with those undergoing conventional off-pump coronary artery bypass grafting (OPCAB). Methods This retrospective cohort study included consecutive patients with multivessel coronary artery disease (CAD) who underwent surgical coronary revascularization at our cardiovascular institute. Patients undergoing non-CABG cardiac procedures or those with incomplete clinical records were excluded. Data were collected on demographic characteristics, cardiovascular comorbidities, operative parameters, duration of postoperative mechanical ventilation, chest tube drainage, and early postoperative complications. Results A total of 80 patients were included, comprising 40 patients who underwent MICS-CABG and 40 who underwent conventional OPCAB. Both groups had a high prevalence of cardiovascular risk factors, including type 2 diabetes mellitus and hypertension. The mean duration of postoperative mechanical ventilation was 8.80 ± 3.97 hours in the MICS-CABG group compared with 4.22 ± 2.64 hours in the OPCAB group. Mean postoperative chest tube drainage was 887.0 ± 611.8 mL in the MICS-CABG group and 328.9 ± 116.1 mL in the OPCAB group. No perioperative mortality occurred in either group, and no conversion from MICS-CABG to median sternotomy was observed. Conclusion MICS-CABG was technically feasible in this early institutional experience, with no perioperative mortality or conversion to sternotomy. However, patients undergoing MICS-CABG had longer postoperative mechanical ventilation and greater chest tube drainage than those undergoing conventional OPCAB. These findings support the feasibility of MICS-CABG while highlighting the need for continued evaluation of outcomes as institutional experience increases.
PMID:42891311 | PMC:PMC13674323 | DOI:10.7759/cureus.116351