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Needle-guided mini-entry in video-assisted coronary artery bypass
Toshiya Ohtsuka1, Mikio Ninomiya, Taisei Maemura
1Department of Cardiovascular Surgery, Tokyo Metropolitan Fuchu General Hospital, 2-9-2 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan. ootsuka-cvs@fuchu-hp.fuchu.tokyo.jp
Summary
This study introduces a video-assisted needle-guided technique for minimally invasive coronary artery bypass surgery. This method precisely guides the surgical entry point, ensuring successful left internal thoracic artery to left anterior descending artery anastomosis with no complications.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Surgical Techniques
Background:
- Minimally invasive coronary artery bypass (MICAB) requires precise localization of target coronary arteries.
- Accurate positioning of the surgical entry is crucial for successful graft anastomosis.
Purpose of the Study:
- To present a novel video-assisted needle-guided technique for precise entry site localization in MICAB.
- To evaluate the safety and efficacy of this technique for left internal thoracic artery (LITA) to left anterior descending (LAD) artery bypass.
Main Methods:
- A video-assisted needle-guided approach was employed to identify the optimal skin entry point for thoracotomy or access-port creation.
- The technique involved thoracoscopic visualization and needle guidance to pinpoint the LAD target site.
- Anastomosis was performed directly through the created mini-entry.
Main Results:
- The technique successfully facilitated direct LITA-LAD anastomosis in all cases, with no conversions required except in a patient with pulmonary dysfunction.
- No mortality or procedure-related morbidity was observed.
- Graft patency was confirmed within a week, and all surviving patients remained event-free at a mean follow-up of 12.5 months.
Conclusions:
- The video-assisted needle-guided technique offers a simple and effective method for accurate mini-entry positioning in MICAB procedures targeting the LAD.
- This approach enhances the feasibility and safety of performing LITA-LAD anastomosis via minimally invasive approaches.