Multiple coronary artery bypass via mini left thoracotomy with conventional aortic occlusion
A Zapolanski1, K Korver, M B Pliam
1San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015-2229, USA.
Insights
Minimally invasive coronary artery bypass grafting (CABG) using the West Coast Technique is safe and effective. This approach allows for complete myocardial revascularization with reduced complications and shorter hospital stays.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Complete myocardial revascularization is achievable via mini left anterior thoracotomy.
- The West Coast Technique utilizes the Port-Access concept with conventional instruments.
Purpose of the Study:
- To evaluate the safety and efficacy of the West Coast Technique for minimally invasive coronary artery bypass grafting (CABG).
Main Methods:
- Thirty-eight patients underwent multiple CABG procedures.
- Aortic occlusion was achieved with a transthoracic clamp for single cross-clamp anastomoses.
Main Results:
- No deaths or neurologic deficits were reported.
- Low rates of perioperative myocardial infarction (MI) and re-exploration for bleeding.
- Average grafts per patient: 2.9; average hospital stay: 5.2 days.
Conclusions:
- Multiple CABG can be safely performed through a minithoracotomy.
- The West Coast Technique eliminates the need for endoaortic occlusion.
Background:
Complete myocardial revascularization can be achieved through a mini left anterior thoracotomy. Our approach (West Coast Technique) takes advantage of the Port-Access (Heartport, Redwood City, CA) concept while utilizing conventional instrumentation.
Methods:
Thirty-eight patients underwent multiple coronary artery bypass grafting (CABG). Aortic occlusion was performed using a transthoracic clamp, and all anastomoses were performed under a single cross-clamp.
Results:
There were no deaths and no neurologic deficits. There was one perioperative myocardial infarction (MI), and one re-exploration for bleeding. Ten patients (26%) required blood transfusions, and five patients (13%) developed atrial fibrillation. The average number of grafts per patient was 2.9, and average hospital stay was 5.2 days.
Conclusion:
Multiple CABG can be accomplished safely through a minithoracotomy, which eliminates the need for endoaortic occlusion.
