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Review paper
Received: 17.12.2022. >> Accepted: 04.04.2023. >> Published: 01.12.2022. Biochemistry
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https://doi.org/10.17392/1571-23

Minimally invasive coronary artery bypass (MICS CABG) in Bosnia and Herzegovina: a single centre, single surgeon cohort experience

By
Nermir Granov Orcid logo ,
Nermir Granov

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

School of Medicine, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Armin Šljivo ,
Armin Šljivo
Contact Armin Šljivo

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Ermina Mujičić ,
Ermina Mujičić

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Damir Rebić ,
Damir Rebić

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Alen Džubur ,
Alen Džubur

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Edin Begić ,
Edin Begić

Department of Cardiology, General Hospital “Prim. Dr Abdulah Nakaš“ , Sarajevo , Bosnia and Herzegovina

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Tarik Selimović ,
Tarik Selimović

Clinical Centre , University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Zlatan Zvizdić ,
Zlatan Zvizdić

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Almir Fajkić ,
Almir Fajkić

School of Medicine, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Asmir Jonuzi ,
Asmir Jonuzi

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Edin Kabil ,
Edin Kabil

Clinical Centre , University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Slavenka Štraus
Slavenka Štraus

Clinical Centre, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

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Abstract

Aim
This is the first research in Bosnia and Herzegovina presenting minimally invasive coronary artery bypass grafting surgery
(MICS CABG) experience, advantages, and outcomes as compared to conventional surgery (OPEN CABG).
Methods
This retrospective cross-sectional study was conducted between January 2019 and November 2022 and included patients
with indication for surgical revascularization.
Results
Among 237 patients, males predominated, 182 (76.7%), with a mean body mass index (BMI) of 28.4±3.9, median The Society of Thoracic Surgery Risk (STS) score of 1.55 (0.8, 4.0), short term STS score of 11.2 (6.8, 23.7), mean age of 64.8±8.7 (ranging 41-83) years, 122 (51.4%) underwent OPEN CABG and 115 (48.6%) MICS CABG. MICS CABG took less time (p<0.001; OPEN 3.5±0.8h; MICS 2.8±0.8h) and needed less mechanical ventilation (p<0.001, OPEN 17.3±11.9h; MICS 13.0±12.5h) than OPEN CABG. Even though there was no difference in hospitalization length between groups (OPEN (7.5±3.2), MICS (7.1±4.0)), patients receiving MICS (2.9±1.5) spent less time in the ICU (p=0.0013) than OPEN CABG (3.6±2.8). OPEN CABG used also more blood derivatives, red blood cells (OPEN 292 vs MICS 55), plasma (OPEN 270 vs MICS 86) and platelets (OPEN 71 vs MICS 28).
Conclusion
Patients undergoing MICS CABG in Bosnia and Herzegovina had less mechanical ventilation hours and less ICU duration compared to OPEN CABG even though the hospitalization duration was very similar. MICS CABG takes less time to be conducted, has fewer CPRs postoperatively, uses less blood derivatives including red blood cells, plasma and platelets.

Keywords:

cardiovascular diseases,
cardiac surgical procedures,
coronary artery disease

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