Coronary Artery Bypass Grafting

Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study☆☆☆

“…From 2007 onward, all proximal anastomoses were handsewn onto the ascending aorta after the application of a side-biting clamp, using a technique of aortic exposure described elsewhere ( Fig. 1) [1,2]. For distal anastomoses, a Starfish TM NS apical positioner and an Octopus TM NS (Medtronic, Minneapolis, MN, USA) were used.…”

“…Since its development by Drs Rene Favaloro and Donald Effler in 1967, coronary artery bypass grafting (CABG) has become one of the most important surgical procedures in the history of medicine [1]. By revolutionizing the natural history and quality of life of patients with ischemic heart disease, arguably, no other operation has prolonged more lives and provided more symptom relief.…”

Designing the coronary artery bypass surgery operation of the future

“…However, CPB leads to inflammation and occasional incidents that are not well captured by randomized controlled trials or even large case series. For instance, cannulation incidents, protamine reactions, and malperfusion events can occur on a rare, episodic basis [4]. There is little question that if a procedure allows one to safely and as effectively avoid the use of CPB, the better it would be.…”

“…However, for most patients who undergo CABG nowadays, the invasiveness of the operation has not appreciably decreased compared with what it entailed more than 50 years ago [2,3]. The performance of a sternotomy, the harvesting of conduits, and the use of cardiopulmonary bypass result in surgical invasion and deleterious physiological changes that have been well described [4]. Blood loss around CABG can also be significant, and the possibility of stroke and wound infection carry very negative implications.…”

Outcomes after different non-sternotomy approaches to left single-vessel revascularization: a comparative study with up to 10-year follow-up

“…Coronary artery bypass grafting (CABG) has revolutionized the natural history and quality of life of patients with ischaemic heart disease by providing more symptomatic relief than any other surgical procedure in the history of medicine [1]. Up to date, CABG with cardiopulmonary bypass (CPB) is considered the gold standard for surgical coronary revascularization [2].…”