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[The case report of minimal access CABG for triple-vessel disease]
T Fujimatsu1, K Hayashi, M Gushiken
1Department of Cardiovascular Surgery, Urasoe General Hospital, Okinawa, Japan.
Insights
A minimally invasive coronary artery bypass grafting (CABG) procedure successfully treated triple-vessel disease. All three grafts remained patent, demonstrating the efficacy of this approach for complex coronary artery disease.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Coronary Artery Bypass Grafting
Background:
- Triple-vessel disease necessitates surgical intervention for effective revascularization.
- Traditional sternotomy for Coronary Artery Bypass Grafting (CABG) carries significant morbidity.
- Minimally invasive approaches offer potential benefits in reducing surgical trauma.
Observation:
- A 55-year-old male patient with triple-vessel disease underwent CABG via a limited left parasternal thoracotomy (10 cm).
- Extracorporeal circulation was established, and myocardial protection was achieved using antegrade cold cardioplegia.
- Sequential grafting of saphenous vein grafts to posterolateral (PD) and obtuse marginal (OM) branches and left internal thoracic artery to the left anterior descending (LAD) artery was performed.
Findings:
- The minimally invasive CABG procedure was completed successfully.
- Postoperative coronary angiography confirmed the patency of all three grafts (saphenous vein grafts and left internal thoracic artery).
- The patient experienced an uneventful recovery and was discharged one week postoperatively.
Implications:
- Minimally invasive CABG via limited thoracotomy is a viable and effective option for treating complex triple-vessel disease.
- This approach may lead to reduced postoperative recovery times and improved patient outcomes.
- Further research into long-term outcomes and broader application of this technique is warranted.
Abstract:
A 55-year-old male patient underwent CABG for triple-vessel disease using the minimal access approach. The procedure was performed through a limited (10 cm) left para-sternal thoracotomy using extracorporeal circulation established with a usual aortic cannula, and pulmonary arterial and right atrial drainage. The myocardium was protected by antegrade administration of cold cardioplegic solution while the aorta was being cross-clampled. The saphenous vein graft was connected sequentially to the 4 PD and OM branches, and the left internal thoracic artery was grafted to the LAD. The postoperative course was uneventful and coronary angiography showed that all three grafts were patent. The patient was discharged one week postoperatively.