# Impact of surgical urgency on outcomes after minimally invasive coronary artery bypass surgery: a retrospective cohort study

## TL;DR

Urgent minimally invasive heart surgery is linked to higher risks like kidney issues and breathing problems compared to planned surgeries.

## Contribution

This study identifies specific postoperative risks associated with urgent minimally invasive coronary surgery.

## Key findings

- Urgent surgeries required more vasopressor support during operations.
- Urgent cases had higher postoperative serum creatinine levels and more acute respiratory failure.
- Preoperative renal function was worse in urgent surgery patients.

## Abstract

Surgical urgency in minimally invasive coronary artery bypass grafting (MICS-CABG) is associated with increased perioperative risk. This study evaluates the impact of surgical urgency on early postoperative outcomes in patients undergoing isolated MICS-CABG.

A retrospective cohort study was conducted at Shar Hospital, Erbil, Iraq, including 311 patients who underwent isolated MICS-CABG between September 2021 and December 2024. Patients were classified as elective group (n = 285) and urgent group (n = 26) according to Society of Thoracic Surgeons criteria. Baseline demographics, intraoperative variables, and early postoperative outcomes were compared using appropriate statistical tests with a significance level of p < 0.05.

Baseline characteristics, including, gender, and body mass index, showed no significant differences between elective and urgent groups. However, the urgent group had significantly lower preoperative left ventricular ejection fraction (49.2% ± 12.0 vs. 53.8% ± 10.0, p = 0.032) and higher preoperative serum creatinine levels (1.59 ± 1.58 vs. 1.19 ± 1.94 mg/dL, p = 0.008). Intraoperatively, urgent patients required more vasopressor support (adrenaline: 26.9% vs. 10.2%, p = 0.020; noradrenaline: 73.1% vs. 40.7%, p = 0.001). Postoperatively, urgent cases had higher serum creatinine (1.86 ± 1.79 vs. 1.14 ± 0.58 mg/dL, p = 0.037) and more frequent incidence of acute respiratory failure in urgent group (39.1% vs. 17.5%, p = 0.023).

Urgent MICS-CABG was associated with increased vasopressor use, renal dysfunction, and respiratory complications.

Not applicable.