Multiple minimally invasive direct coronary artery bypass grafting for the complete revascularization of the left ventricle

Watanabe, Go; Misaki, Takuro; Kotoh, Keiju; K, Kawakami; Yamashita, Akio; Ueyama, Keishi

doi:10.1016/s0003-4975(99)00473-7

Cited by 28 publications

(14 citation statements)

References 10 publications

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“…However, by using novel approaches such as limited lateral thoracotomy and the L-fi gure approach reported by Watanabe et al, multiple bypass surgery has become possible without CPB and sternotomy. 26,27 Although the skin incision is longer than that with the LAST approach, patients with two-or three-vessel disease can benefi t from these approaches. Weerasinghe and Bahrami also reported bilateral mini-thoracotomy for bilateral ITA harvesting and multiple revascularization.…”

Section: Discussionmentioning

confidence: 99%

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Coronary artery bypass grafting without full sternotomy

Sasaki

2009

Surg Today

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Coronary artery bypass grafting is performed without full sternotomy in selected patients because it is less invasive. Left internal thoracic artery-left anterior descending artery bypass (LITA-LAD bypass) via a small left anterior thoracotomy is a well established procedure, which achieves good graft patency with low mortality and morbidity rates. Multiple revascularization is possible with a limited lateral thoracotomy or L-figure approach. Axillary-coronary bypass and right gastroepiploic artery-right coronary artery bypass (RGEA-RCA bypass) are alternative methods, especially for redo surgery, in selected patients.

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Section: Discussionmentioning

confidence: 99%

“…Watanabe et al described a limited lateral thoracotomy approach to revascularize the LAD and CX, 26 performed for 20 patients. The mean length of the skin incision was 10.9 ± 1.2 cm.…”

Section: Limited Lateral Thoracotomymentioning

confidence: 99%

Coronary artery bypass grafting without full sternotomy

Sasaki

2009

Surg Today

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“…6 For left anterior descending arterial and circumflex arterial lesions, multiple minimally invasive direct coronary artery grafting (MIDCABG) through a small left thoracotomy may be performed without cardiopulmonary bypass. 7 When using a free graft (vein or radial artery), proximal anastomosis may be performed on the descending aorta or left subclavian artery. 8 Two important points must be considered regarding anesthesia for the thoracotomy approaches.…”

Section: Discussionmentioning

confidence: 99%

Mitral valve replacement and tricuspid annuloplasty via right mini-thoracotomy in a patient with tracheostomy

et al. 2003

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This report describes our experience in performing mitral valve replacement and tricuspid annuloplasty via a right mini-thoracotomy in a patient with tracheostomy. A 24-year-old woman was admitted with shortness of breath and palpitations. She had subglottic tracheal stenosis and tracheostomy due to tracheal intubation of long duration. Echocardiography revealed chronic severe mitral and tricuspid valve regurgitation. We planned to perform at first the cardiac, and then the tracheal operation, because her left ventricular function was worsening. To eliminate the potential complications of sternotomy in patients with tracheostomy, we used right mini-thoracotomy. We performed mechanical mitral valve replacement for the mitral valve and De Vega annuloplasty for the tricuspid valve. The patient was transferred to the tracheal surgery clinic after the 20th day. Tracheal resection and anastomosis were performed in this department. Three months later, the patient was asymptomatic. We believe that the right mini-thoracotomy approach is a good technique for mitral valve replacement in patients with tracheostomy.

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“…Although the majority of the literature on MIDCAB has focused on LAD revascularisation, it is worth mentioning that grafting of all the coronary territories of the heart can be achieved through a wide range of sternum-sparing incisions (11)(12)(13)(14)(15)(16)(17) . Table 1 presents a list of the possible surgical approaches and their target coronary vessels.…”

Section: Limited Access Sternum-sparing Revascularisation Approaches mentioning

confidence: 99%

Minimal access coronary revascularistaion without cardiopulmonary bypass- The impact of robotic technology in the current clinical practice

Casula¹,

Athanasiou²,

Darzi³

2004

IJMRCAS

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Recent advances in interventional cardiology and cardiac surgery have changed the traditional therapeutic algorithms by altering indications, timing and patterns of referral for subsequent surgical treatment. The traditional longitudinal sternomy incision has been the surgical approach of choice for multi-vessel coronary revascularisation. Drawbacks of this incision include potential postoperative morbidity, which translates to a prolonged postoperative length of stay. The combination of minimally invasive direct coronary artery bypass (MIDCAB) with percutaneous transluminal coronary angioplasty (PTCA) or stenting (a hybrid approach) is an alternative therapeutic method for patients with multivessel coronary artery disease. Recent advances in percutaneous interventions have attempted to address the problem of re-stenosis, initially through the deployment of bare metal intra-coronary stents and, more recently, with drug-eluting stents. Developments in coronary revascularisation have focused on reducing both surgical invasiveness and trauma. Patients with significant co-morbid pathologies, the ones undergoing re-interventions, and especially the elderly may benefit from such hybrid procedures by avoiding cardiopulmonary bypass and midline sternotomy. Minimally invasive techniques have revolutionized cardiothoracic surgery by increasing patient satisfaction and by reducing surgical trauma, hospital stay and consequently overall costs. There are however limitations. Robot assisted surgery endeavours to minimise these technical hindrances and so allow better and more accurate surgical practice whilst minimising surgical trauma.

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Multiple minimally invasive direct coronary artery bypass grafting for the complete revascularization of the left ventricle

Cited by 28 publications

References 10 publications

Coronary artery bypass grafting without full sternotomy

Coronary artery bypass grafting without full sternotomy

Mitral valve replacement and tricuspid annuloplasty via right mini-thoracotomy in a patient with tracheostomy

Minimal access coronary revascularistaion without cardiopulmonary bypass- The impact of robotic technology in the current clinical practice

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