Multivessel Total Arterial Revascularization via Left Thoracotomy

Singh, Sushil Kumar; Mishra, Surya Kumar; Kumar, Deepak; Yadave, Ram Deo; Sinha, Subhash Kumar

doi:10.1177/021849230401200108

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…30,31 In 2 other publications, single-center thoracotomy multivessel grafting with a configuration similar to that in the present series was reported in as many as 255 patients. 27,32 Although the thoracotomies were larger (allowing central cannulation via the right atrial appendage and aorta) and used external sternotomy off-pump CABG instruments through the incision, the authors noted good results, including low mortality and an incidence of atrial fibrillation that ranged between 5.5% and 8%.…”

Section: Mics Cabg Versus Other Multivessel Minimally Invasive Technisupporting

confidence: 77%

Minimally Invasive Coronary Artery Bypass Grafting

et al. 2009

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Background-Minimally invasive coronary artery bypass grafting (MICS CABG) is a novel coronary operation that does not require infrastructure and is potentially available to all cardiac surgeons. It aims at decreasing the invasiveness of conventional CABG while preserving the applicability and durability of surgical revascularization. We examined the feasibility and safety of MICS CABG in the first large series of this operation to date. Methods and Results-All myocardial territories are accessed via a 4-to 6-cm left fifth intercostal thoracotomy. An apical positioner and epicardial stabilizer are introduced into the chest through the subxyphoid and left seventh intercostal spaces, respectively. The left internal thoracic artery is used to graft the left anterior descending artery, and radial artery or saphenous vein segments are used to graft the lateral and inferior myocardial territories. Proximal anastomoses are performed directly onto the aorta or from the left internal thoracic artery as a T-graft. In the first 450 consecutive MICS CABG procedures at our 2 centers, meanϮSD age was 62.3Ϯ10.7 years and 123 patients were female (27%). The average number of grafts was 2.1Ϯ0.7, with complete revascularization in 95% of patients. There were 34 patients in whom cardiopulmonary bypass was used (7.6%), 17 conversions to sternotomy (3.8%), and 10 reinterventions for bleeding (2.2%). Perioperative mortality occurred in 6 patients (1.3%). Conclusions-MICS CABG is feasible and has excellent procedural and short-term outcomes. This operation could potentially make multivessel minimally invasive coronary surgery safe, effective, and more widely available.

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Section: Mics Cabg Versus Other Multivessel Minimally Invasive Technisupporting

confidence: 77%

Minimally Invasive Coronary Artery Bypass Grafting

et al. 2009

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“…À exceção do paciente com oclusão de enxerto, todos os demais tiveram o teste ergométrico negativo após 60 dias da operação. O crescimento das populações de maior risco, como os diabéticos [9] e os pacientes submetidos a múltiplos procedimentos [10], pode mudar a maneira como indicamos a cirurgia para a RM face ao custo adicional de reintervenções com uso das próteses farmacológicas de alto custo.…”

Section: Resultsunclassified

Revascularização miocárdica por minitoracotomia esquerda: série de casos

Gauze

Rosa²,

Salvi³

et al. 2007

Rev Bras Cir Cardiovasc

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“…There are very few studies [1][2][3] in literature, which have reported complete primary revascularization via a thoracotomy incision . We present our initial experience using this approach to off pump coronary artery revascularization.…”

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confidence: 99%

Off Pump coronary artery revascularization via left thoracotomy —Early results

Bhaskar

Sharma

2007

Indian J Thorac Cardiovasc Surg

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IntroductionOver the past few years, there has been an increasing stress on eliminating or at least minimizing the morbidity associated with cardiopulmonary bypass. The advent of mechanical stabilizers and intracoronary shunts has greatly contributed and facilitated the trend towards beating heart coronary revascularization. Consequently, off pump coronary artery bypass grafting technique is being increasingly used as an alternative to conventional on pump coronary artery bypass in many centers worldwide. Off pump coronary revascularization via left thoracotomy though AbstractBackground: There are very few studies in literature, which have reported primary revascularization of the coronaries via a thoracotomy incision. We hereby present our initial experiences using this approach to off pump coronary revascularization.Patients and Methods: 27 patients with coronary artery disease were selected for surgical revascularization via the thoracotomy approach. The left chest is entered through the 5 th intercostal space, and the left internal mammary artery (LIMA) pedicle is harvested under direct vision. The radial artery or saphenous vein is harvested simultaneously depending on the availability and suitability of the conduits. Using standard off pump techniques, the LIMA is anastomosed to the Left Anterior Descending Artery (LAD) followed by other distal anastomoses.Results: Complete revascularization was achieved in all patients. The average number of grafts were 2.40. The mean blood loss during the first 6 hours was 380 ± 169 ml. None of the patients needed emergency conversion to cardiopulmonary bypass / sternotomy. Post operatively 4 patients had on table extubation. 1 patient was re-explored due to bleeding from the thoracotomy. There was no peri-operative Myocardial infarction and the mortality was nil. The average hospital stay was 6.4 ±1 days.Conclusion: Based on our initial experience, this approach appears to be safe and practical in selected cases. It is well tolerated hemodynamically, with minimal postoperative morbidity. (Ind J Thorac Cardiovasc Surg 2007; 23: 236-239)

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Multivessel Total Arterial Revascularization via Left Thoracotomy

Cited by 8 publications

References 7 publications

Minimally Invasive Coronary Artery Bypass Grafting

Minimally Invasive Coronary Artery Bypass Grafting

Revascularização miocárdica por minitoracotomia esquerda: série de casos

Off Pump coronary artery revascularization via left thoracotomy —Early results

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