Minimally invasive direct coronary artery bypass as a primary strategy for reoperative myocardial revascularization

Lognathen Balacumaraswami, Nirav C. Patel, Hagen Gorki, Joan Jennings, Konstadinos A. Plestis, Valavanur A. Subramanian

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: Conventional reoperative coronary artery bypass grafting is associated with risk of sternal re-entry, injury to patent grafts, and embolization from diseased grafts. Sternal sparing minimally invasive direct coronary artery bypass (MIDCAB) avoids such risks in cases where it is technically feasible. We sought to examine in-hospital outcomes of reoperative MIDCAB surgery. Methods: We recorded prospective standardized data from the New York Cardiac Surgical Reporting System database of 369 reoperative MIDCAB cases from 1996 to 2006 and compared with 822 primary MIDCAB patients in the same time period. We compared the preoperative risk profile and postoperative in-hospital outcomes and length of stay for both groups. Results: There was a significantly higher risk profile typical of the reoperative patient population (P < 0.001 for stroke, peripheral/cerebrovascular disease, extensive aortic calcification, renal failure, and left ventricular ejection fraction <40%) compared with the primary MIDCAB group. Despite this fact, there was no difference in the in-hospital outcomes and length of hospital stay between the two groups. Conclusions: Reoperative MIDCAB provides targeted coronary revascularization and avoids hazards of sternal re-entry, graft injury and manipulation, and deleterious effects of cardiopulmonary bypass. This hastens recovery and provides excellent early outcomes equivalent to primary MIDCAB procedures.

Original languageEnglish (US)
Pages (from-to)22-27
Number of pages6
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Issue number1
StatePublished - 2010

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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