Coronary disease & ACSRandomised controlled trial
Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial
- Randomised controlled trial
- investigator-initiated
- international
- open-label
- multicentre (7 centres)
Authors' conclusion
For selected patients with multivessel coronary artery disease, MICS CABG performed by experienced teams improved patient-reported physical recovery at 1 month compared with sternotomy CABG, with no apparent safety penalty through to 12 months.
Study context
- Population
- Adults with multivessel CAD referred for coronary artery bypass grafting (CABG), suitable for both sternotomy and minimally invasive cardiac surgery (MICS) CABG176 enrolled
- Participants
- 170 adults
- Comparison
- MICS CABG via small thoracotomy vs sternotomy CABG
- MICS CABGn = 86
- Sternotomy CABGn = 84reference
- Primary endpoint
- Patient-reported physical recovery (SF-36 PCS score)
- Follow-up
- 1 month
Primary result
SF-36 PCS score
Mean difference
2.9
95% CI 0.3–5.5
P = 0.031
By group
MICS CABG
45.1
mean · SD 8.0
Sternotomy CABG
42.2
mean · SD 9.1
MICS CABG vs Sternotomy CABG
mean difference 2.9 (95% CI 0.3–5.5); P = 0.031
As reported in the abstract
Further findings
Death, stroke and MACCE · up to 12 months
- Deaths or strokes in either group
- 0
- MACCE in MICS CABG (before 1 month)
- 1
- MACCE in Sternotomy CABG
- 0
- according to treatment received
- 12-month follow-up complete except 3 patients in Sternotomy CABG
Original publication
Multivessel coronary artery bypass grafting via small thoracotomy versus sternotomy (MIST): an investigator-initiated, international, open-label, randomised controlled trial. Lancet. Published 31 July 2026. doi:10.1016/s0140-6736(26)01288-2
Summarised from the published abstract; every number is checked against it