Minimally Invasive Coronary Artery Bypass Surgery in Patients With Multi Vessel Coronary Disease

Launched by UNIVERSITY OF SAO PAULO GENERAL HOSPITAL · Jan 20, 2025

Keywords

ClinConnect Summary

Minimally invasive surgery has been a breakthrough in medicine, especially in more developed countries. It represents an evolution of current techniques associated with new technologic devices, that allow a safe and effective procedure associated to an aesthetic benefit.

Invasive treatment of coronary artery disease has been on a plateau lately. Percutaneous treatment that emerged as a promise to replace surgical methods, has already shown its limitations, even with the use of drug-eluting stents. Traditional CABG (coronary artery bypass grafting surgery), which has been considered the gol...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients 18-years-old or older
• • Isolated myocardial revascularization procedure
• • Double or Triple-vessel disease with proximal or mid LAD disease with angiographic diameter stenosis \> 70% by visual analysis in all territories, requiring myocardial revascularization OR proximal LAD disease with angiographic diameter stenosis 50-70% by visual analysis in any territory but with invasive or non-invasive evidence of flow-limiting stenosis in all three territories, requiring myocardial revascularization
• • Total SYNTAX score \> 22 or low Syntax score unsuitable for PCI
• • Clinical and anatomic eligibility for both Minimally invasive and Conventional CABG surgery as agreed to by surgical team.
• • Silent ischemia, stable angina, unstable angina or recent MI
• • - If recent MI, cardiac biomarkers must have returned to normal prior to randomization
• • Ability to sign informed consent and comply with all study procedures
• Exclusion Criteria:
• • Reoperation
• • Need for any concomitant cardiac surgery other than CABG (e.g. valve surgery, aortic repair, etc.), or intent that if the patient randomizes to surgery, any cardiac surgical procedure other than isolated CABG will be performed
• • Left ventricle disfunction (EF\<40%)
• • Chronic Pulmonary obstructive disease
• • Renal failure disease
• • Emergency surgery
• • Obesity
• • Sternum anatomic defects including pectus excavatum
• • Peripheral vascular disease
• • Ascending aorta severe calcification
• • Non cardiac co-morbidities with life expectancy less than 1 year