MULTIVESSEL MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING VERSUS CONVENTIONAL CORONARY ARTERY BYPASS GRAFTING VIA MEDIAN STERNOTOMY: AN INTEGRATIVE REVIEW OF PERIOPERATIVE OUTCOMES AND HOSPITAL RECOVERY

Abstract

Multivessel minimally invasive coronary artery bypass grafting (MICS-CABG) has been proposed as an alternative to conventional coronary revascularization via median sternotomy, with potential to reduce surgical trauma and accelerate recovery. Objective: to analyze and synthesize comparative evidence on major perioperative outcomes and in-hospital recovery among adults undergoing multivessel MICS-CABG versus conventional surgery. Methods: integrative review with searches in PubMed/MEDLINE and BVS/LILACS covering studies published from 2015 to September 2026. Critical appraisal was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Cohort Studies. Results: 17 eligible publications corresponding to 13 main studies/cohorts were included. No consistent increase was identified in mortality, myocardial infarction, stroke, or renal complications with MICS-CABG. Some studies reported lower bleeding, transfusion requirements, and length of stay, although findings were heterogeneous. Longer operative time and, in on-pump procedures, longer cardiopulmonary bypass and myocardial ischemia/aortic cross-clamp times were recurrent findings. Conclusion: multivessel MICS-CABG may represent a viable alternative in selected patients and experienced centers, with no consistent signal of worse perioperative safety; however, the predominantly observational evidence does not allow formal demonstration of superiority, equivalence, or noninferiority compared with conventional surgery.