Despite sternum sparing and without cardiopulmonary bypass, the actual value of minimally invasive coronary surgery (MICS) is still debatable. This study aimed to compare the completeness of revascularization and intermediate-term outcomes of MICS with conventional sternotomy coronary artery bypass grafting (CABG).

Two groups of 244 patients each receiving MICS-CABG and sternotomy-CABG between November 2015 and March 2019 were matched by propensity score matching. The completeness of revascularization and major adverse cardiovascular and cerebrovascular events (MACCE; a composite of death, myocardial infarction, stroke, or repeated target vessel revascularization) were compared between the groups.

In the MICS-CABG group, the percentages of bypassed vessels 2, 3, and ≥4 were 53.7%, 36.1%, and 10.2%, respectively. Completeness of revascularization (95.5% vs 96.3%; P = .65) was comparable between MICS-CABG and sternotomy-CABG groups. Postprocedural angiography revealed an overall patency of 96.2% (578/601) for the MICS-CABG group. At 5 years, rates of MACCE (19.9% vs 22.1%; hazard ratio [HR], 0.80; 95% CI, 0.49-1.32; P = .39), death (10.6% vs 12.9%; HR, 0.87; 95% CI, 0.46-1.65; P = .67), myocardial infarction (5.6% vs 4.2%; HR, 0.82; 95% CI, 0.27-2.52; P = .73), stroke (6.7% vs 6.6%; HR, 1.11; 95% CI, 0.43-2.86; P = .83), and repeated target vessel revascularization (1.9% vs 1.8%; HR, 0.85; 95% CI, 0.17-3.15; P = .84) were similar between MICS-CABG and sternotomy-CABG.

MICS-CABG, which appeared to yield noninferior completeness of revascularization and intermediate-term MACCE compared with sternotomy-CABG, could be an alternative for patients with multivessel coronary diseases.