Results Of Coronary Artery Bypass Surgery Through A Mini-Sternotomy In Ischemic Heart Disease
Khalikulov Khusan , PhD, Associate Professor, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan Tilavoldiyev Pahlavonmahmud , Master’s degree, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan Irisov Ortiqali , DSc, Associate Professor, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan Xaydarov Alisher , PhD, Associate Professor, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, Uzbekistan Mirzaev Khondamir , Senior teacher, Department of Surgery and Transplantology, Faculty No. 2, Tashkent State Medical University, Tashkent, UzbekistanAbstract
Ischemic heart disease (IHD) remains the leading cause of morbidity and mortality worldwide, accounting for millions of victims annually. Since the mid-1950s, coronary artery bypass grafting (CABG) performed via a traditional full median sternotomy has served as the gold standard for myocardial revascularization because it provides unsurpassed exposure of the heart and great vessels. However, this conventional approach is frequently characterized by "surgical aggressiveness," which can lead to significant physiological stress, postoperative bleeding, wound infections, and thoracic wall instability. To address these challenges, minimally invasive cardiac surgery (MICS) has emerged as a patient-centered clinical philosophy. These techniques are designed to reduce tissue trauma and mitigate the systemic inflammatory response without compromising the long-term durability of the surgical repair.
This review evaluates the clinical, functional, and postoperative outcomes of CABG performed via mini-sternotomy in patients with IHD, drawing on a synthesis of 14 primary research articles. A primary focus is placed on assessing myocardial recovery through intraoperative graft patency measurements and the analysis of cardiac markers. The review further investigates complication rates, with a specific examination of postoperative atrial fibrillation (POAF), bleeding volumes, and the incidence of wound infections compared with traditional surgery. Additionally, this analysis evaluates the efficacy of postoperative rehabilitation by examining mechanical ventilation duration, length of hospital stay, and health-related quality of life, including the management of sharp neuropathic pain associated with minimal-access incisions. By aggregating these results, the review aims to define the feasibility and safety of the mini-sternotomy approach in modern revascularization.
Keywords
Ischemic heart disease, coronary artery bypass grafting, mini-sternotomy
References
Alat, I., & Celik, E. (2018). Off-pump coronary artery bypass grafting surgery through manubrium sparing mini-sternotomy. Austin Journal of Clinical Trials: Open Access, 1(1), 1001.
Aston, D., Zeloof, D., & Falter, F. (2023). Anaesthesia for minimally invasive cardiac surgery. Journal of Cardiovascular Development and Disease, 10(11), 462. https://doi.org/10.3390/jcdd10110462
Birla, R., Patel, P., Aresu, G., & Asimakopoulos, G. (2013). Minimally invasive direct coronary artery bypass versus off-pump coronary surgery through sternotomy. Annals of The Royal College of Surgeons of England, 95(7), 481–485. https://doi.org/10.1308/003588413X13629960050513
Dost, B., Turunc, E., Aydin, M. E., Kaya, C., Aykut, A., Demir, Z. A., Narayanan, M., & De Cassai, A. (2025). Pain management in minimally invasive cardiac surgery: A review of current clinical evidence. Pain and Therapy, 14, 913–930. https://doi.org/10.1007/s40122-025-00280-1
El-Sayed Ahmad, A., Salamate, S., & Bakhtiary, F. (2023). Lessons learned from 10 years of experience with minimally invasive cardiac surgery. Frontiers in Cardiovascular Medicine, 9, 1053572. https://doi.org/10.3389/fcvm.2023.1053572
Elassal, A. A., Al-Ebrahim, K. E., Makhdoom, A. M., Fatani, M. A., & Ibrahim, M. H. (2021). Hybrid coronary revascularization: Perspective current state after 25 years of start. The Heart Surgery Forum, 24(2), E347–E359. https://doi.org/10.1532/hsf.3111
Gianoli, M., de Jong, A. R., Jacob, K. A., Namba, H. F., van der Kaaij, N. P., van der Harst, P., & Suyker, W. J. L. (2022). Minimally invasive surgery or stenting for left anterior descending artery disease – meta-analysis. IJC Heart & Vasculature, 40, 101046. https://doi.org/10.1016/j.ijcha.2022.101046
Maimari, M., Baikoussis, N. G., Gaitanakis, S., Dalipi-Triantafillou, A., Katsaros, A., Kantsos, C., Lozos, V., & Triantafillou, K. (2020). Does minimal invasive cardiac surgery reduce the incidence of post-operative atrial fibrillation? Annals of Cardiac Anaesthesia, 23(1), 7–13. https://doi.org/10.4103/aca.ACA_70_19
Palma Dallan, L. R., Ferreira Lisboa, L. A., Oliveira Dallan, L. A., Vilca Mejia, O. A., Neves Filho, A. F., Doenst, T., Babliak, O., Orellana Sampedro, G. A., & Jatene, F. B. (2025). Minimally invasive coronary artery bypass grafting (MINI-CABG): Protocol for a pilot randomized controlled trial. PLoS ONE, 20(12), e0337829. https://doi.org/10.1371/journal.pone.0337829
Poddi, S., & Rungatscher, A. (2026). Minimally invasive cardiac surgery: A state-of-the-art review. Journal of Clinical Medicine, 15(3), 371. https://doi.org/10.3390/jcm15030371
Sipahi, N. F. (2017). Pain intensity and graft patency following minimally invasive coronary artery bypass grafting (Doctoral dissertation, Johann Wolfgang Goethe-Universität).
Su, P., Gu, S., Liu, Y., Zhang, X., Yan, J., An, X., Gao, J., Xin, Y., & Zhou, J. (2018). Off-pump coronary artery bypass grafting with mini-sternotomy in the treatment of triple-vessel coronary artery disease. International Heart Journal, 59(4), 474–481. https://doi.org/10.1536/ihj.18-058
Sugita, J., & Fujiu, K. (2018). Systemic inflammatory stress response during cardiac surgery. International Heart Journal, 59(4), 457–459. https://doi.org/10.1536/ihj.18-057
Vignaroli, W., Pala, B., Nasso, G., Sechi, S., Campolongo, G., Speziale, G., & Navarra, E. M. (2026). Mini- and micro-invasive approaches in cardiac surgery: Current techniques, outcomes, and future perspectives. Medicina, 62(1), 102. https://doi.org/10.3390/medicina62010102
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Copyright (c) 2026 Khalikulov Khusan, Tilavoldiyev Pahlavonmahmud, Irisov Ortiqali, Xaydarov Alisher, Mirzaev Khondamir

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