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.
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.
