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<p>The aim of this meta-analysis was to systematically evaluate the early and mid-term outcomes of minimally invasive multivessel coronary artery bypass grafting (MICS-CABG) compared with conventional bypass surgery with medial sternotomy CABG (ST-CABG). Only propensity score-matched studies including true multivessel revascularization (≥ 2 distal anastomoses) were included. In total, 6 studies comprising 1806 patients (903 MICS-CABG vs. 903 ST-CABG) were analyzed.</p><p>Random effects meta-analysis demonstrated no significant differences in in-hospital mortality between the two approaches. Likewise, no significant differences were observed in mid-term clinical endpoints, including 5‑year overall survival and freedom from major adverse cardiac and cerebrovascular events (MACCE).</p><p>Importantly, a consistent positive trend favoring MICS-CABG was observed with respect to perioperative complications and length of hospital stay. In particular, transfusion rates and overall in-hospital stay were numerically lower in the minimally invasive group, suggesting a&#xa0;potentially reduced perioperative burden and enhanced postoperative recovery.</p><p>These findings indicate comparable early and mid-term safety of both MICS-CABG and ST-CABG in selected patients, with potential advantages of the minimally invasive approach in terms of postoperative recovery. Ongoing prospective randomized trials are expected to further validate and confirm these results.</p>

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Chirurgische koronare Mehrgefäßrevaskularisation: minimalinvasiv vs. konventionelle Sternotomie

  • 期刊论文

  • 发表日期：

    2026年8月1日

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  • Mohammed Al-Tawil,
  • Alish Kolashov,
  • Nora de Silva,
  • Kim Sophie Frey,
  • Abdel Hannan Diab,
  • Philip Kolat,
  • Assad Haneya

摘要

The aim of this meta-analysis was to systematically evaluate the early and mid-term outcomes of minimally invasive multivessel coronary artery bypass grafting (MICS-CABG) compared with conventional bypass surgery with medial sternotomy CABG (ST-CABG). Only propensity score-matched studies including true multivessel revascularization (≥ 2 distal anastomoses) were included. In total, 6 studies comprising 1806 patients (903 MICS-CABG vs. 903 ST-CABG) were analyzed.

Random effects meta-analysis demonstrated no significant differences in in-hospital mortality between the two approaches. Likewise, no significant differences were observed in mid-term clinical endpoints, including 5‑year overall survival and freedom from major adverse cardiac and cerebrovascular events (MACCE).

Importantly, a consistent positive trend favoring MICS-CABG was observed with respect to perioperative complications and length of hospital stay. In particular, transfusion rates and overall in-hospital stay were numerically lower in the minimally invasive group, suggesting a potentially reduced perioperative burden and enhanced postoperative recovery.

These findings indicate comparable early and mid-term safety of both MICS-CABG and ST-CABG in selected patients, with potential advantages of the minimally invasive approach in terms of postoperative recovery. Ongoing prospective randomized trials are expected to further validate and confirm these results.