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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
[Coronary surgery with minimum access and cardiopulmonary bypass]
C Barriuso Vargas1, M Castellá Pericas, E Greco
1Servicio de Cirugía Cardiovascular, Hospital Clínic de Barcelona, Universidad de Barcelona.
Insights
This study demonstrates that minimal incision coronary artery bypass surgery using femoral cannulation and antegrade cardioplegia is safe and effective. Patients experienced reduced hospital stays and avoided sternotomy complications, showing promising results for myocardial revascularization.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Coronary Artery Bypass Grafting
Background:
- Sternotomy is the traditional approach for coronary artery bypass grafting (CABG).
- Sternotomy is associated with significant complications and prolonged recovery.
- Alternative minimally invasive techniques are being explored to improve patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of a minimally invasive CABG technique.
- To assess outcomes including complications, intensive care unit (ICU) stay, and hospital stay.
- To determine the feasibility of this approach for selected patients.
Main Methods:
- Seven patients underwent minimally invasive CABG with femoral cannulation and antegrade blood cardioplegia.
- Procedures included left internal thoracic artery grafting and saphenous vein grafts.
- The "endoclamp" (Heartport Inc.) was utilized for aortic occlusion.
Main Results:
- Median cardiopulmonary bypass time was 75 minutes; median aortic occlusion time was 33 minutes.
- No major complications were reported; two minor complications occurred.
- Median ICU stay was 2 days; median hospital stay was 6.5 days.
- All patients achieved New York Heart Association (NYHA) Functional Class I at 3-6 months follow-up.
Conclusions:
- Minimally invasive CABG with femoral cannulation avoids sternotomy-related complications.
- This technique reduces ICU and hospital stay, leading to better convalescence.
- This approach is a viable option for an increasing number of selected patients undergoing myocardial revascularization.
Abstract:
From October 1997 to March 1998 we operated on seven patients with minimal incision, cardiopulmonary by-pass with femoral cannulation and antegrade blood cardioplegic arrest using the "endoclamp" (Heartport Inc.). The seven patients with isolated severe lesions of the left anterior descending underwent a left internal thoracic artery graft under direct vision. Three had saphenous vein coronary bypass grafts performed to the diagonal (2) and obtuse marginal branches of the left coronary artery. The median cardiopulmonary bypass duration was 75 minutes (30-230) and the aortic occlusion time was 33 minutes (10-117). No major complications occurred and only two minor ones were noted. The median intensive care unit stay was 2 days (1 to 4) and the total hospital stay was 6.5 days (3 to 13). All the patients are in NYHA FC I, without treatment and a follow up of 3 to 6 months after the surgery. With this method of myocardial revascularization with minimal incision and cardiopulmonary bypass the sternotomy-related complications can be avoided, the intensive care unit and hospital stay can be reduced with better convalescence for the selected patients. We believe that this technique is a valid option for an increasing number of patients.
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