• Omar Toubar, Ming Hao Guo, Christine Ashenhurst, Menaka Ponnambalam, David Glineur, and Marc Ruel.
• Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Faculty of Medicine, McGill University, Quebec, Canada.
• J. Thorac. Cardiovasc. Surg. 2024 Nov 25.

ObjectivesMinimally invasive coronary artery bypass grafting (MICS CABG) allows visualization and revascularization of all myocardial territories through a small anterolateral thoracotomy, with or without cardiopulmonary bypass. It is increasing in popularity as a safe and effective alternative to sternotomy CABG. In this study, we examine the correlates and long-term outcomes of repeat revascularization (RR) in MICS CABG patients.MethodsWe prospectively followed all patients on annual or semi-annual basis who had undergone MICS CABG surgery over a 17-year period at a single institution. Cumulative incidence of RR was calculated accounting for competing risk of mortality. Kaplan-Meier curves were compared with log-rank test for survival and freedom from cardiac death at 12-years for both groups. Multivariable Cox proportional hazard models were performed to identify variables associated with RR and its impact on long-term survival.ResultsClinical follow-up was complete for 100% of patients (N=566) at a mean of 7.0±4.4 years. Forty-nine (8.7%) patients required RR after their MICS CABG, for a cumulative incidence at 12 years of 14.8 ± 2.5%. The most common indication was progression of native coronary disease in 23 (46.9% of RR) patients. Perioperative transfusion was the only variable associated with RR (HR 5.0; 95%CI: 2.4, 10.3). Comparing patients who had RR versus those who did not, there was no significant difference in late survival (92.1±4.5% vs. 80.3±3.0%; P=0.18).ConclusionsAmong 566 patients who underwent MICS CABG over a 17-year period, RR was an infrequent event affecting 8.7% of patients, with no negative impact on long-term survival.Copyright © 2024. Published by Elsevier Inc.

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