Minimally invasive coronary artery bypass grafting

• Published in: The Annals of thoracic surgery Vol. 61; no. 1; pp. 135 - 137
• Main Authors: Acuff, Tea E., Landreneau, Rodney J., Griffith, Bartley P., Mack, Michael J.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 1996; Elsevier Science
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary; Biological and medical sciences; Coronary Angiography; Endoscopy; Humans; Internal Mammary-Coronary Artery Anastomosis - methods; Length of Stay; Male; Medical sciences; Minimally Invasive Surgical Procedures; Postoperative Complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Thoracoscopy; Vascular Patency; Human; Treatment; Aortocoronary; Bypass; Surgery; Cardiovascular disease; Anterior intraventricular artery; Technique; Coronary heart disease
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(95)00907-8

Standard options for the invasive management of proximal disease of the left anterior descending coronary artery include coronary artery bypass grafting with a left internal mammary artery and percutaneous transluminal coronary angioplasty. We describe a surgical technique for bypass of the left anterior descending coronary artery with a left internal mammary artery without median sternotomy and without cardiopulmonary bypass. Thoracoscopy is used to harvest the internal mammary artery, whereas the mammary-coronary artery anastomosis is performed under direct vision through a limited anterior thoracotomy. We have performed this procedure successfully in 3 patients with minimal morbidity and shortened hospital stay. Average operative time was 3 hours and postoperative hospital stay averaged less than 48 hours. Although experience is limited and follow-up is very short, with further experience, this less invasive surgical technique may become a viable option for the management of proximal left anterior descending disease.