Classical or minimaly invasive coronary revascularization surgery? What's the difference?

Yıl 2026, Cilt: 9 Sayı: 1, 103 - 108, 17.03.2026

Bülent Meşe , Feragat Uygur , Ömer Çokkalender

https://izlik.org/JA46YS69SU

Öz

ABSTRACT
Background
The aim of coronary bypass surgery is complete revascularization. As a current method that provides this and minimizes patient choice, we aimed to report the classic CABG (Coronary Artery Bypass Graft surgery) series performed by the same team during the same period with the TCRAT ( Total Coronary Revascularization via Small Left Anterior Thoracotomy) method by comparing it with in-hospital and 30-day results.
Methods
This study included 250 patients with multivascular lesions who underwent total coronary revascularization with the TCRAT method between January 2020 and January 2024, and 250 patients who underwent conventional CABG by the same team during the same period. All patients underwent surgery using standard surgical instruments, and all underwent two or more distal anastomoses.
Results
In the operative data, CPB(Cardio Pulmonary Bypass) time was 68.3±15.7 minutes and cross-clamp time was 34±10.6 minutes in the CABG group, while in the TCRAT group, CPB time was 102.8±23.3 minutes and cross-clamp time was 63.7±23.3 minutes. (p<0.001). The postoperative blood transfusion requirement during the intensive care period was 2±0.6 units in the CABG group and 0.8±0.4 units in the TCRAT group (p<0.001). The extubation time for patients in the intensive care unit was 11±1.6 hours in the CABG group and 6.5±1 hours in the TCRAT group (p=0.001). New postoperative AF development was observed in 45 (18%) patients in the CABG group, compared to 22 (8.8%) in the TCRAT group (p=0.003). The revision rate, including suture and debridement, was limited to 75 (30%) patients in the CABG group and 5 (2%) in the TCRAT group (p<0.001).
Conclusion
When the likelihood of delayed wound and bone healing and return to daily life increases with conventional CABG, the TCRAT technique can be considered as an alternative surgical method.

Anahtar Kelimeler

minimally invasive cardiac surgery , coronary artery bypass grafting , revascularization , left anterior thoracotomy

Klasik veya minimal invaziv koroner revaskülarizasyon cerrahisi? Farkı nedir?

https://izlik.org/JA46YS69SU

Öz

ÖZET
Arka plan
Koroner bypass cerrahisinin amacı tam revaskülarizasyondur. Bunu sağlayan ve hasta seçimini en aza indiren güncel bir yöntem olarak, aynı ekip tarafından aynı dönemde yapılan klasik CABG (Koroner Arter Bypass Greft cerrahisi) serisini TCRAT (Küçük Sol Anterior Torakotomi ile Total Koroner Revaskülarizasyon) yöntemi ile hastane içi ve 30-günlük sonuçları açısından karşılaştırmayı amaçladık.
Yöntemler
Bu çalışma Ocak 2020 ile Ocak 2024 arasında TCRAT yöntemiyle total koroner revaskülarizasyon yapılan 250 multivasküler lezyonlu hasta ile aynı dönemde aynı ekip tarafından klasik CABG yapılan 250 hastayı kapsamaktadır. Tüm hastalar standart cerrahi aletler kullanılarak ameliyat edildi ve hepsinde iki veya daha fazla distal anastomoz yapıldı.
Sonuçlar
Operatif verilerde CPB (Kardiyopulmoner Bypass) süresi 68.3±15.7 dakika, kros klemp süresi CABG grubunda 34±10.6 dakika, TCRAT grubunda ise CPB süresi 102.8±23.3 dakika ve kros klemp süresi 63.7±23.3 dakika idi. (p<0.001). Yoğun bakım döneminde ameliyat sonrası kan transfüzyonu gereksinimi KABG grubunda 2±0.6 ünite, TCRAT grubunda 0.8±0.4 ünite idi (p<0.001). Yoğun bakım ünitesindeki hastaların ekstübasyon süresi KABG grubunda 11±1.6 saat, TCRAT grubunda 6.5±1 saatti (p=0.001). CABG grubunda 45 (%18) hastada, TCRAT grubunda ise 22 (%8.8) hastada yeni postoperatif AF gelişimi gözlendi (p=0.003). Dikiş ve debridman dahil revizyon oranı CABG grubunda 75 (%30) hasta ile sınırlı iken TCRAT grubunda 5 (%2) hastada görüldü (p<0.001).
Sonuç
Konvansiyonel CABG ile yara ve kemik iyileşmesinin gecikmesi ve günlük hayata dönüşün uzaması olasılığı arttığında TCRAT tekniği düşünülebilir.

Anahtar Kelimeler

minimal invazif kardiyak cerrahi , koroner arter baypas greft , revaskülarizasyon , sol anterior torakotomi

Kaynakça

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