Results Of Coronary Artery Bypass Surgery Through A Mini-Sternotomy In Ischemic Heart Disease
Abstract
Ischemic heart disease (IHD) remains the leading cause of morbidity and mortality worldwide, accounting for millions of victims annually. Since the mid-1950s, coronary artery bypass grafting (CABG) performed via a traditional full median sternotomy has served as the gold standard for myocardial revascularization because it provides unsurpassed exposure of the heart and great vessels. However, this conventional approach is frequently characterized by "surgical aggressiveness," which can lead to significant physiological stress, postoperative bleeding, wound infections, and thoracic wall instability. To address these challenges, minimally invasive cardiac surgery (MICS) has emerged as a patient-centered clinical philosophy. These techniques are designed to reduce tissue trauma and mitigate the systemic inflammatory response without compromising the long-term durability of the surgical repair.
This review evaluates the clinical, functional, and postoperative outcomes of CABG performed via mini-sternotomy in patients with IHD, drawing on a synthesis of 14 primary research articles. A primary focus is placed on assessing myocardial recovery through intraoperative graft patency measurements and the analysis of cardiac markers. The review further investigates complication rates, with a specific examination of postoperative atrial fibrillation (POAF), bleeding volumes, and the incidence of wound infections compared with traditional surgery. Additionally, this analysis evaluates the efficacy of postoperative rehabilitation by examining mechanical ventilation duration, length of hospital stay, and health-related quality of life, including the management of sharp neuropathic pain associated with minimal-access incisions. By aggregating these results, the review aims to define the feasibility and safety of the mini-sternotomy approach in modern revascularization.
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References
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