Early Postoperative Recovery Outcomes of Minimally Invasive Versus Conventional Cardiac Surgery in Adult Patients in Pakistan: A Retrospective Cohort Study
Authors
Fatima Jaweria1,6*, Myada A. Ibrahim2,6, Zia Un Nisa3, Saman Aziz4, Muhammad Muzammil Ramzan5
1 Ibadat International University, Islamabad, Pakistan
2 University of Global Health Equity (UGHE), Rwanda
3 National Institute of Health, Islamabad, Pakistan
4 Riphah International University, Islamabad, Pakistan
5 Farooq Teaching Hospital
6 The Operating Room Global (TORG)
Corresponding Author: Fatima Jaweria · [email protected]
Study Summary
Background
Cardiac surgery is indicated when medical therapy fails to control myocardial ischemia, ventricular dysfunction, or hemodynamic instability. Conventional full sternotomy carries substantial perioperative trauma, while minimally invasive cardiac surgery (MICS) aims to reduce access-related morbidity, though evidence from Pakistan remains limited. This study compared early postoperative recovery and examined factors associated with prolonged ventilation and short intensive care unit (ICU) stay after MICS versus conventional surgery.
Methods
In this retrospective cohort study, records of 98 adults (49 conventional, 49 MICS) undergoing coronary or valvular surgery at a single tertiary center in Pakistan between November 2025 and May 2026 were analyzed using the Mann–Whitney U test, chi-square or Fisher’s exact test, and multivariable binary logistic regression.
Results
MICS was associated with significantly shorter ventilation time, shorter ICU stay, and lower intra-aortic balloon pump (IABP) use (6.1% vs 22.4%; p=0.040). Inotropic support and re-exploration favored MICS without reaching conventional statistical significance. Surgical approach was the only independent predictor of short ICU stay (AOR 7.47, 95% CI 2.28–24.55, p=0.001) and approached significance for prolonged ventilation (AOR 8.59, 95% CI 1.00–73.88, p=0.050).
Conclusion
MICS was associated with faster early recovery than conventional surgery in this Pakistani cohort, despite higher BMI and longer operative time. Given the retrospective design, these findings reflect association rather than causation and support prospective evaluation of MICS in Pakistani tertiary centers.
Keywords: Minimally Invasive Surgical Procedures · Cardiac Surgical Procedures · Postoperative Care · Intensive Care Units · Intra-Aortic Balloon Pumping
Postoperative Outcomes at a Glance
Postoperative Support Requirements
Predictors of Early Recovery
Study Design & Analytical Approach
A quantitative retrospective cohort study comparing early postoperative recovery following minimally invasive and conventional cardiac surgery at a single tertiary-care cardiac center in Pakistan.
Study Period
November 2025–May 2026
Participants
Adults undergoing CABG or valve surgery.
Sampling
Quota-based consecutive sampling to 49 patients per group.
Analysis
SPSS 26; t-test/Mann–Whitney U, chi-square/Fisher’s exact test, and binary logistic regression.
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Article Details
Original Research
Retrospective cohort study of early postoperative cardiac-surgery recovery.
Editorial Timeline
Received 26 August 2026
Accepted 19 September 2026
Available Online 25 September 2026
CC BY 4.0
Creative Commons Attribution 4.0 International licence.
Conflict & Funding
No conflicts of interest. No specific funding; conducted under the TORG Global Research Fellowship (Mentorship Track).
Volume 2 · Issue 3
September 2026 · ISSN 3105-3262
DOI: 10.64573/torgj2608007
TORG-IRB
Approval reference TORG-IRB/2026/032501; protocol ID TORG-IRB-20260325-01; approved 6 May 2026. Retrospective medical-record abstraction began after approval.
Drafting & Formatting Support
Claude (Anthropic) was declared for drafting, restructuring, formatting and reference-list reformatting from the authors’ original dissertation data and analysis. It was not used to collect, generate, analyze or interpret study data or results.
Pakistan
Single high-volume tertiary-care cardiac center with conventional and minimally invasive cardiac surgical services.
Author Contributions (CRediT)
Fatima Jaweria: Project administration, Conceptualization, Methodology, Data curation, Formal analysis, Investigation, Writing – original draft.
Myada A. Ibrahim: Supervision, review and editing. Zia Un Nisa: Writing, review and editing. Saman Aziz: Writing, review and editing. Muhammad Muzammil Ramzan: Writing, review and editing.
All authors approved the final manuscript and take responsibility for the integrity of the work.