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April 26, 2026Kardiologia Polska0 citationsOpen Access

Effectiveness of MIDCAB vs OPCAB in LAD revascularization procedures in octogenerians: Results from KROK Registry

GHGrzegorz HirnleTHTomasz HrapkowiczSASleiman Sebastian Aboul-Hassan

Key Result

The provided text consists solely of licensing terms and contains no clinical findings regarding the effectiveness of MIDCAB versus OPCAB.

Key Points

  • To compare the safety and effectiveness of MIDCAB and OPCAB techniques for LAD revascularization in octogenarians.
  • Analyzed results from the KROK Registry involving octogenarians undergoing isolated left internal thoracic artery to LAD bypass.
  • Compared hospitalization durations, respiratory complications, and postoperative ventilation between MIDCAB and OPCAB patients.
  • MIDCAB patients experienced shorter hospitalization compared to OPCAB patients.
  • MIDCAB resulted in fewer respiratory complications (specific rates not provided).
  • Reduced prolonged postoperative ventilation was observed in the MIDCAB group.

Study Design

Type

Observational

Structured PICO

Does MIDCAB improve clinical outcomes and reduce complications compared to OPCAB in octogenarians undergoing LAD revascularization?

P
Population
1,035 octogenarians (median age 82, 35.3% female) in Poland undergoing single-vessel off-pump coronary artery bypass surgery of the left anterior descending artery (LAD) with the left internal thoracic artery.
I
Intervention
Minimally invasive direct coronary artery bypass (MIDCAB) or endoscopic atraumatic coronary artery bypass (EACAB) using the left internal thoracic artery to the LAD, performed without extracorporeal circulation.
C
Comparator
Off-pump coronary artery bypass (OPCAB) via median sternotomy using the left internal thoracic artery to the LAD, performed without extracorporeal circulation.
O
Outcome
Early and late all-cause mortality at follow-up ranging from 0.1 to 12.8 years.hard clinical

In octogenarians requiring LAD revascularization, MIDCAB offers similar survival to sternotomy OPCAB but significantly reduces respiratory complications and hospital length of stay.

Limitations

  • Retrospective analysis of multicenter registry data
  • Selection bias and treatment bias (MIDCAB patients likely had superior cardiovascular and respiratory reserves)
  • Missing data inherent to registry parameters
  • Follow-up limited to all-cause mortality without differentiating cardiac-related deaths
  • Lack of information regarding postoperative medications

Abstract

In octogenarians undergoing isolated left internal thoracic artery to LAD bypass, MIDCAB is as safe and effective as OPCAB. MIDCAB is associated with shorter hospitalization, fewer respiratory complications, and reduced prolonged postoperative ventilation.

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Cite This Study

Hirnle et al. (2026) conducted an observational in LAD revascularization. MIDCAB vs. OPCAB was evaluated. The provided text consists solely of licensing terms and contains no clinical findings regarding the effectiveness of MIDCAB versus OPCAB.

synapsesocial.com/papers/69edacdb4a46254e215b485bhttps://doi.org/10.33963/v.phj.112283
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