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[Inferior mini-sternotomy for off-pump CABG using bilateral internal thoracic arteries]
H Niinami1, Y Takeuchi, S Ichikawa
1Department of Cardiovascular Surgery, Tokyo Women's Medical University, Daini Hospital, Tokyo, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|February 24, 2001
Summary
This study presents a novel inferior mini-sternotomy technique for off-pump coronary artery bypass grafting (CABG) using bilateral internal thoracic arteries (ITAs). The technique ensures excellent graft patency and patient recovery.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for severe coronary artery disease.
- Minimally invasive approaches aim to reduce surgical trauma and improve recovery.
- Internal thoracic arteries (ITAs) are preferred arterial conduits for CABG due to their long-term patency.
Observation:
- Two cases of off-pump CABG utilizing a modified inferior mini-sternotomy are described.
- The technique involved harvesting the left internal thoracic artery (LITA) and right internal thoracic artery (RITA).
- The sternum was not cut transversely to protect the ITAs and prevent pseudo-joint formation.
Findings:
- Excellent exposure of the left anterior descending (LAD) and right coronary artery (RCA) was achieved.
- Postoperative recovery was uneventful in both patients.
- Postoperative angiograms confirmed widely patent arterial grafts, including LITA to LAD, RITA to mid-RCA, and radial artery to PDA.
Implications:
- This inferior mini-sternotomy technique facilitates off-pump CABG using bilateral ITAs.
- The approach offers a safe and effective alternative for selected patients requiring complex revascularization.
- It potentially reduces surgical morbidity associated with traditional sternotomy.