{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:44:05Z","timestamp":1789087445677,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) surgery, performed through a left minithoracotomy, has emerged as an alternative to conventional coronary artery bypass grafting (CABG), which requires a full sternotomy. This procedure is ideal for patients with isolated proximal left anterior descending (LAD) artery disease or high surgical risk. The aim of this study was to assess the long-term clinical outcomes of MIDCAB performed at a single center with stratification by revascularization strategy. Methods: A total of 480 patients who underwent off-pump MIDCAB between 2012 and 2024 at a single center were retrospectively analyzed and categorized into three distinct groups: complete revascularization (MIDCAB-CR), hybrid coronary revascularization (MIDCAB-HCR) and incomplete revascularization (MIDCAB-IR). Short- and long-term outcomes, including mortality, major adverse cardiac and cerebral events (MACCE) and LITA\u2013LAD graft patency were evaluated. Median follow-up was 3.39 years. Results: In-hospital mortality was 1.4%. At a median follow-up duration of 3.39 years, the overall LITA\u2013LAD graft patency was 94.4% with 5- and 10-year survival rates of 78% and 60%, respectively. MIDCAB-CR and MIDCAB-HCR groups showed comparable long-term survival and freedom from MACCE, both significantly better than those observed in the MIDCAB-IR groups. Conclusions: These findings support the safety and durability of MIDCAB as an effective revascularization strategy, especially when performed as complete or hybrid revascularization. Incomplete revascularization may be considered in selected high-risk patients but is associated with worse outcomes.<\/jats:p>","DOI":"10.3390\/jcm14217590","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:16:24Z","timestamp":1761729384000},"page":"7590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-Term Clinical Outcomes of Minimally Invasive Direct Coronary Artery Bypass Grafting"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-7466","authenticated-orcid":false,"given":"Sleiman Sebastian","family":"Aboul-Hassan","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"},{"name":"Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, 65-046 Zielona Gora, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7679-4388","authenticated-orcid":false,"given":"Maria","family":"Luszczyn","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"},{"name":"Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, 65-046 Zielona Gora, Poland"},{"name":"The Student Society of Cardiac Surgery, Collegium Medicum University of Zielona Gora, 65-046 Zielona Gora, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryszard","family":"Stanislawski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Peksa","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Nawotka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siarhei","family":"Amelchanka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukasz","family":"Moskal","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2054-8199","authenticated-orcid":false,"given":"Tomasz","family":"Stankowski","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sana Heart Center Cottbus, 03048 Cottbus, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romuald","family":"Cichon","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zbigniew Religa Heart Center \u201cMedinet\u201d, 67-100 Nowa Sol, Poland"},{"name":"Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, 65-046 Zielona Gora, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Iribarne, A., Zwischenberger, B., Mehaffey, J., Kaneko, T., Wyler von Ballmoos, M.C., Jacobs, J.P., Krohn, C., Habib, R.H., Parsons, N., and Badhwar, V. 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