Simple exposure of the internal thoracic artery for minimally invasive coronary artery bypass

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Minimally Invasive Surgery

Background:

• Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
• Minimally invasive techniques aim to reduce surgical trauma and improve recovery.
• Harvesting the internal thoracic artery (ITA) pedicle is crucial for successful CABG.

Purpose of the Study:

• To describe a simple, safe, and cost-effective method for harvesting the ITA pedicle.
• To evaluate the early and long-term outcomes of this harvesting technique in minimally invasive CABG.

Main Methods:

• A simple technique using a small scapular retractor for ITA pedicle harvesting was developed.
• The technique was applied in 39 patients undergoing minimally invasive CABG.
• Postoperative angiography assessed graft patency; clinical follow-up monitored outcomes.

Main Results:

• The ITA pedicle harvesting technique was successfully used in 39 patients.
• Early postoperative angiography showed a 96% graft patency rate.
• Long-term follow-up (mean 9.6 months) in 63% of patients demonstrated a 95.4% cumulative patency rate with no evidence of graft 'steal'.
• No perioperative deaths or myocardial infarctions occurred; only 2 patients experienced recurrent angina.

Conclusions:

• This simple ITA pedicle harvesting technique is safe and effective for minimally invasive CABG.
• The method offers high graft patency and favorable clinical outcomes.
• It presents an inexpensive and viable surgical option for selected patients.