[Off-pump coronary artery bypass using bilateral in situ internal thoracic artery grafts for left coronary artery
Insights
Off-pump coronary artery bypass (OPCAB) using bilateral in situ internal thoracic arteries (ITAs) successfully treated severe coronary artery disease. This technique achieved high-quality, well-patent grafts without cardiopulmonary bypass.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Triple vessel disease and intracranial arterial stenoses pose significant surgical challenges.
- Off-pump coronary artery bypass (OPCAB) aims to avoid cardiopulmonary bypass complications.
Observation:
- A 63-year-old male patient with complex coronary artery disease underwent OPCAB.
- The procedure involved three grafts: left internal thoracic artery (left ITA) to left anterior descending, right ITA to circumflex artery, and saphenous vein graft to right coronary artery.
- Specialized tools like Octopus 2 and the "Lima" suture technique were employed.
Findings:
- The surgery was completed in 355 minutes with 440 ml blood loss.
- Postoperative recovery was uneventful.
- Angiography confirmed all three grafts were patent and functioning well.
Implications:
- Bilateral in situ ITA utilization in OPCAB can yield high-quality surgical outcomes.
- This approach offers a viable alternative for patients with extensive coronary and intracranial arterial disease.
- Minimally invasive techniques in complex cardiac surgery can lead to successful results.
Abstract:
A 63-year-old man with triple vessel disease in the coronary artery and multiple arterial stenoses in intra-cranial vessels underwent off-pump coronary artery bypass (OPCAB). We were able to perform three coronary artery bypass grafting (in situ left internal thoracic artery (left ITA)--left anterior descending artery, in situ right ITA--circumflex artery through the transverse sinus, and saphenous vein graft--right coronary artery) using octopus 2 and "Lima" suture technique without cardio-pulmonary bypass. Operation time was 355 minutes and established blood loss was 440 ml. Postoperative course was uneventful. Postoperative angiogram revealed well patent three grafts. Using bilateral in situ ITAs OPCAB could achieve high quality.
