Multivessel Coronary Artery Bypass Grafting via Small Thoracotomy Versus Sternotomy (MIST): An Investigator-Initiated, International, Open-Label, Randomised Controlled Trial

In this international randomized trial, 170 selected patients with multivessel coronary artery disease underwent minimally invasive coronary artery bypass grafting (CABG) through a small thoracotomy (n=86) or conventional sternotomy (n=84). At one month, patient-reported physical recovery was better after minimally invasive CABG, with mean 36-item Short Form Health Survey (SF-36) Physical Component scores of 45.1 versus 42.2 (difference 2.9, 95 percent confidence interval [CI] 0.3–5.5; p=0.031). The median age was 67 years, and 91 percent were male. Through 12 months, there were no deaths or strokes in either group, and only one major adverse cardiac or cerebrovascular event occurred after minimally invasive CABG. In experienced centers, minimally invasive CABG improved early recovery without an apparent safety penalty.