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Coronary artery bypass grafting on the beating heart using the octopus method--a case report
1Department of Anesthesia, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C. tanph@gcn.net.tw
Insights
A 74-year-old male with severe coronary artery disease underwent minimally invasive direct coronary artery bypass (MIDCAB) surgery. This procedure successfully addressed complex blockages in the left anterior descending and circumflex arteries.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- A 74-year-old male presented with persistent chest tightness.
- Previous percutaneous transilluminal coronary angioplasty (PTCA) for single-vessel disease one year prior.
Observation:
- Cardiac catheterization revealed 90% stenosis in the left anterior descending (LAD) and circumflex (CX) coronary arteries.
- Repeat PTCA was deemed suboptimal for the complex lesions.
Findings:
- Minimally invasive direct coronary artery bypass (MIDCAB) was selected due to patient condition and lesion characteristics.
- The surgical procedure utilized an Octopus tissue stabilizer for optimal outcomes.
Implications:
- This case highlights the successful application of MIDCAB for complex coronary artery disease.
- Effective anesthetic management and surgical technique are crucial for MIDCAB success.
Abstract:
A 74-year-old male was admitted due to chest tightness for one month. He had received percutaneous transilluminal coronary angioplasty (PTCA) because of single-vessel disease one year ago. Cardiac catheterization examination carried out during this admission revealed 90% stenosis of the left anterior descending coronary artery (LAD) and circumflex branch (CX). Because another attempt of PTCA was considered not optimal, the patient was advised to undergo surgical grafting to which he consented. After expediently balancing the merits and demerits of every practicable surgical procedure--the essential determinant in selection of which was that the patient's condition and criteria of indication of that procedure were in perfect harmony--we decided to carry out minimally invasive direct coronary artery bypass (MIDCAB) with the application of Octopus tissue stabilizer. We report the surgical course and anesthetic management of the patient and discourse some detail in MIDCAB.
