Exposures of Lateral and Inferior Cardiac Surface for Coronary Anastomosis during Minimally Invasive Coronary Artery Bypass Grafting

Pande, Shantanu; Gupta, Devendra; Siddartha, CR; Bansal, Anubhav; Agarwal, Surendra Kumar

doi:10.1097/imi.0000000000000116

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Left internal mammary artery was used to graft left anterior descending artery while right internal mammary artery was used to graft obtuse marginal and posterior descending artery in a sequential fashion. 13 At the end of surgery an epidural catheter was placed in the SAP after ensuring that activated clotting time was less than 130 seconds. Linear ultrasonography (USG) probe (6 to 13 MHz) was placed in the coronal plane along mid-axillary line, fifth rib identified ( Fig.…”

Section: Surgical Techniquementioning

confidence: 99%

Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients Undergoing MIDCAB Surgery

Gautam

Pande

Agarwal

et al. 2020

Innovations�(Phila)

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Objective The minimally invasive direct coronary artery bypass (MIDCAB) surgery is associated with severe chest pain in the first 2 to 3 postoperative days; this may delay the patient recovery. In this randomized controlled trial we evaluated the role of serratus anterior plane (SAP) block for postoperative pain relief in patients undergoing MIDCAB surgery. Methods Patients undergoing MIDCAB surgery were randomized into 2 groups of 25 each; SAP group received 20 mL of 0.2% ropivacaine with 1 μg/mL fentanyl as bolus followed by infusion at 8 mL/h; control group received saline for both bolus and infusion. Primary outcome measure was postoperative pain when supine, and during deep inspiration, coughing, and patient movement; secondary outcome measures were requirement of postoperative intravenous fentanyl and opioid-related side effects. All patients were followed at 6-hourly intervals for 48 hours in the postoperative period. Results were analyzed by the Student’s t -test, χ 2 test, Mann–Whitney U-test and Kruskall–Wallis test. A P-value <0.05 was considered significant. Results The 2 groups were similar with respect to patient characteristics. Static and dynamic pain visual analog scale scores were significantly reduced in the SAP group as compared to the control group at most of the time points of assessment ( P < 0.05). Patient-controlled fentanyl requirements were reduced in the SAP group as compared to control group on the second postoperative day ( P < 0.05). Conclusions SAP block reduced the postoperative pain scores and opioid requirements in patients undergoing MIDCAB surgery.

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Section: Surgical Techniquementioning

confidence: 99%

Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients Undergoing MIDCAB Surgery

Gautam

Pande

Agarwal

et al. 2020

Innovations�(Phila)

Self Cite

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“…In MICS CABG, limited space for visualization and heart manipulation adds technical difficulty when constructing anastomoses to the lateral or post‐inferior epicardial vessels 13 . This might be associated with impaired graft patency and incomplete revascularization (ICR).…”

Section: Introductionmentioning

confidence: 99%

Graft patency and completeness of revascularization in minimally invasive multivessel coronary artery bypass surgery

Zhang

Gong

et al. 2021

J Card Surg

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Objectives Graft patency and completeness of revascularization were analyzed in patients who underwent off‐pump minimally invasive coronary artery bypass grafting via a left small thoracotomy. Methods We retrospectively reviewed the invasive angiography findings and clinical data of 186 consecutive patients who underwent off‐pump minimally invasive coronary artery bypass grafting via a left small thoracotomy. The left internal thoracic artery and saphenous vein were used to bypass two or more of three coronary artery systems: the left anterior descending artery, left circumflex artery, or right coronary artery. Before hospital discharge, invasive angiography was performed to assess graft patency. Clinical variables during hospitalization and follow‐up were collected and analyzed. Results All 186 patients successfully underwent off‐pump minimally invasive coronary artery bypass grafting without conversion to sternotomy or assistance of cardiopulmonary bypass. The mean graft number was 2.81 per patient (range, 2–5), and the total number of grafts was 522. The in‐hospital mortality rate was 1.6% (3 of 186). A total of 181 of 186 (97.3%) patients underwent postoperative invasive angiography. Among the 510 grafts assessed by angiography, the total graft patency rate was 96.3% (491 of 510) (98.3% [171 of 174] for left internal thoracic artery grafts and 95.2% [318 of 334] for saphenous vein grafts). The rate of complete revascularization was 99.5% (185 of 186). Conclusions Minimally invasive coronary artery bypass grafting using left internal thoracic artery and saphenous vein grafts provides acceptable graft patency and completeness of revascularization for selected patients with multivessel disease.

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“…Cranial trephination is the earliest form of surgical procedure widely adopted in both the Old World and the New World from the Early Neolithic [ 1 – 6 ]. This type of surgery, first documented in Epipaleolithic and Mesolithic hunter-gatherers [ 1 , 7 – 11 ], most likely originated in Morocco around 11–12,000 BP [ 12 – 15 ]. It is still practiced at the present time among some tribes especially in Central Africa [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Early Medical Skull Surgery for Treatment of Post-Traumatic Osteomyelitis 5,000 Years Ago

et al. 2015

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Here we describe the findings of a unique example of the early techniques adopted in neurosurgery around 5000 years ago, consisting in a double well healed skull trephination associated with a post-cranial traumatic event occurring intra vitam to a young male from the Early Chalcolithic cemetery of Pontecagnano (South Italy, ca. 4,900 - 4,500 cal BP). Morphological, X-ray and 3D-CT scan skull-cap evaluation revealed that the main orifice was produced by scraping, obtained by clockwise rotary motion of a right-handed surgeon facing the patient, while the partial trephination was carried out by using a stone point as a drilling tool. In both cases, bone regrowth is indicative of the individual's prolonged postoperative survival and his near-complete recovery. The right femur shows a poorly healed mid-shaft fracture presumably induced by a high energy injury, and a resulting chronic osteomyelitis, affecting both femurs by hematogenous spread of the infection. Our observations on the visual and radiological features of skull and femur lesions, along with evidence on the timing of experimental bone regrowth vs. healing of lower limb fractures associated to long-term bone infections now suggest that this young man underwent a double skull trephination in order to alleviate his extremely painful condition induced by chronic osteomyelitis, which is thought to have been the cause of death.

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Exposures of Lateral and Inferior Cardiac Surface for Coronary Anastomosis during Minimally Invasive Coronary Artery Bypass Grafting

Cited by 3 publications

References 11 publications

Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients Undergoing MIDCAB Surgery

Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients Undergoing MIDCAB Surgery

Graft patency and completeness of revascularization in minimally invasive multivessel coronary artery bypass surgery

Early Medical Skull Surgery for Treatment of Post-Traumatic Osteomyelitis 5,000 Years Ago

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