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Minimally invasive coronary surgery in women
1Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei, Taiwan, China.
Insights
Minimally invasive coronary artery bypass grafting is a feasible surgical option for triple vessel disease in women. This approach offers good cosmetic results and no late deaths or angina in follow-up.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Techniques
- Coronary Artery Disease
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for severe coronary artery disease.
- Minimally invasive surgical approaches are increasingly explored to reduce surgical trauma and improve patient outcomes.
Purpose of the Study:
- To evaluate the feasibility and outcomes of minimally invasive surgery for coronary artery bypass grafting in patients with triple vessel coronary artery disease.
Main Methods:
- Nine female patients with triple vessel disease underwent minimally invasive CABG via a limited left parasternal incision.
- Procedures utilized femorofemoral extracorporeal circulation and direct vision for graft anastomosis.
- Left internal thoracic artery and saphenous vein grafts were used for revascularization.
Main Results:
- An average of 3.7 distal anastomoses were performed per patient.
- Mean aortic cross-clamp and extracorporeal circulation times were 82 and 115 minutes, respectively.
- All patients had uneventful postoperative courses, short hospital stays, and no late adverse events at a mean 6.4-month follow-up.
Conclusions:
- Minimally invasive CABG is technically feasible for triple vessel coronary artery disease.
- This approach may serve as a viable alternative, particularly for female patients.
- Positive patient satisfaction and cosmetic outcomes were noted.
Objective:
To evaluate the minimally invasive surgery in coronary artery bypass grafting and the feasibility for revascularization of triple vessel coronary artery disease.
Methods:
Nine female patients, aged 49.1 to 81.6 years (mean 64.3), were operated on for triple vessel disease through minimally invasive surgical techniques. The surgeries were performed through limited left parasternal incision under femorofemoral extracorporeal circulation. The myocardium was protected by antegrade infusion of cold blood cardioplegic solution while the aorta was cross-clamped. Under direct vision, the left saphenous vein grafts were connected sequentially to the diagonal branch, obtuse marginal branch and posterior descending branch, and the left internal thoracic arterial graft was anastomosed to the left anterior descending artery in each patient.
Results:
The number of distal anastomoses was 3 to 4 with a mean of 3.7. The aortic crossclamp time was 52 to 130 minutes (82 +/- 25 minutes). The duration of extracorporeal circulation was 78 to 151 minutes (115 +/- 29 minutes). The postoperative course was uneventful in all patients. The postoperative length of stay was 4 to 12 days (7.2 +/- 2.0 days). Follow-up (4.2 to 8.7 months, mean 6.4) was complete in all patients and there were no late deaths or angina. Coronary angiography of 2 patients showed patent grafts. All patients were satisfied with the good cosmetic healing of the incision.
Conclusion:
Our experience demonstrates that minimally invasive surgery in coronary artery bypass grafting is technically feasible and may be an alternative approach in surgical revascularization of triple vessel coronary artery disease, especially in female patients.