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Minimally invasive internal thoracic artery harvest: the hybrid approach
M Massetti1, G Babatasi, P Nataf
1Thoracic and Cardiovascular Surgery, University Hospital, Caen, France.
Insights
Harvesting the left internal thoracic artery (LITA) during minimally invasive coronary artery bypass grafting (CABG) is challenging. A novel hybrid technique combining direct vision dissection and thoracoscopy offers an effective solution for LITA harvesting.
Area of Science:
- Cardiothoracic Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Minimally invasive coronary artery bypass grafting (CABG) without cardiopulmonary bypass presents challenges in safely harvesting the left internal thoracic artery (LITA).
- Achieving complete LITA dissection via limited approaches is technically demanding and time-consuming, necessitating innovative surgical strategies.
Purpose of the Study:
- To review existing surgical approaches and technical considerations for LITA harvesting in minimally invasive CABG.
- To propose a preferred hybrid technique for LITA harvesting.
Main Methods:
- Review of surgical experience and techniques for LITA harvesting.
- Description of a hybrid approach combining direct vision dissection and thoracoscopic completion.
Main Results:
- Existing techniques for LITA harvesting in minimally invasive CABG are discussed.
- The proposed hybrid technique facilitates safe and efficient LITA dissection.
Conclusions:
- A hybrid technique integrating direct vision and thoracoscopy is presented as a preferred method for LITA harvesting.
- This approach addresses the challenges associated with LITA dissection in minimally invasive CABG.
Background:
Safe harvesting of the left internal thoracic artery is a difficult problem during minimally invasive coronary artery bypass grafting without cardiopulmonary bypass. A complete internal thoracic artery dissection through a limited approach is technically demanding and time consuming and different techniques have been proposed.
Methods And Results:
Based on our experience, the different surgical approaches and technical considerations are reviewed.
Conclusions:
A hybrid technique using dissection under direct vision and completed by thoracoscopy is discussed and proposed as our preferred technique of internal thoracic artery harvesting.