Beating-heart totally endoscopic coronary artery bypass grafting: Report of a case

This case report presents beating-heart totally endoscopic coronary artery bypass grafting (TECAB) for single-vessel coronary artery disease. A 72-year-old man with isolated left anterior descending (LAD) coronary artery disease was considered eligible for TECAB. Left internal thoracic artery (LITA)...

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Published inSurgery today (Tokyo, Japan) Vol. 40; no. 1; pp. 57 - 59
Main Authors Nishida, Satoru, Watanabe, Go, Ishikawa, Norihiko, Kikuchi, Yujiro, Takata, Munehisa, Ushijima, Teruaki
Format Journal Article
LanguageEnglish
Published Japan Springer Japan 01.01.2010
Subjects
Aged
Case Report
Coronary Artery Bypass, Off-Pump - methods
Coronary Artery Disease - surgery
Endoscopy - methods
Humans
Male
Medicine
Medicine & Public Health
Sternotomy - methods
Sternum - surgery
Surgery
Surgical Oncology
Thoracotomy - methods
Totally endoscopic coronary artery bypass grafting
Off-pump
da Vinci
Robot
Beating heart
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Summary:This case report presents beating-heart totally endoscopic coronary artery bypass grafting (TECAB) for single-vessel coronary artery disease. A 72-year-old man with isolated left anterior descending (LAD) coronary artery disease was considered eligible for TECAB. Left internal thoracic artery (LITA) mobilization and subsequent off-pump revascularization applying the LITA to the LAD in a closed chest environment was performed using the da Vinci surgical system (Intuitive Surgical, Mountain View, CA, USA). The LITA was first harvested completely in a totally skeletonized fashion through three incisions 1–2 cm long in the left thoracic wall. The LAD was immobilized with the aid of a heart stabilizer. The LITA was then anastomosed to the LAD with 10 interrupted sutures of a Nitinol self-closing S15 U-clip device (Medtronic, Minneapolis, MN, USA) on the beating heart without the use of cardiopulmonary bypass. The time acquired to perform anastomosis was 20 min, and the total operative time was 5 h 34 min. The postoperative course was uneventful and the patient was discharged 5 days after the operation. Beating-heart TECAB was successfully performed for this patient with single-vessel LAD disease. This approach may be an evolutionary step toward beating-heart multivessel TECAB.
Bibliography:ObjectType-Case Study-2
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ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-009-4004-y