Minimally Invasive Total Arterial Bypass Grafting via Left Minithoracotomy in Obese Patients

This single-center study assessed the safety and efficacy of minimally invasive total arterial off-pump coronary artery bypass grafting (MICS-CABG) via left minithoracotomy in obese patients (BMI ≥30) compared to nonobese controls. Among 279 patients (2015–2023), 56 were obese. Despite higher comorbidities and European System for Cardiac Operative Risk Evaluation (EuroSCORE) II in obese patients, the 30-day mortality rate was zero percent. Complication rates (e.g., wound infections, bleeding, low cardiac output) did not significantly differ between groups. At five years, survival (91.6 percent for obese patients vs. 92.4 percent for nonobese patient) and freedom from major adverse cardiovascular and cerebrovascular events (MACCE) (83.3 percent vs. 84.5 percent) were comparable. Most patients received bilateral internal mammary artery (BIMA) grafts, and no conversions to sternotomy occurred in obese patients.