Related Experiment Video
Updated: Aug 21, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Multivessel, all-arterial, off-pump surgical revascularization without disruption of the thoracic skeleton
1Pensacola Heart Institute, Pensacola, Florida, USA. thomas_vassiliades@emoryhealthcare.org
Purpose:
To evaluate the feasibility of performing multivessel off-pump surgical revascularization without manipulation of the thoracic cage.
Description:
The technique consists of bilateral thoracoscopic internal mammary artery harvesting followed by a nonrib-spreading, muscle-sparing opening in the soft tissue of the thorax. An endoscopic cardiac positioner and stabilizers exposes and steadies the target arteries beneath a small opening. Anastomoses are constructed off-pump through the natural width of the intercostal space without the need for rib spreading.
Evaluation:
Fifty-two patients underwent all-arterial, off-pump revascularization through incisions avoiding manipulation of the thoracic skeleton. The mean number of grafts per patient was 2.2 +/- 0.4. Transit time flow measurements verified graft patency before closure in all cases. The mean operating time was 4.4 hours (range, 3.4 to 5.6). Hospital length of stay was 2.6 +/- 1.9 days. There was no early or late mortality. Postoperative angiography performed in 63.8% of the grafts (74 of 116) revealed an overall patency rate of 98.6%.
Conclusions:
A grafting approach that avoids any manipulation of the thoracic skeleton offers significant patient value and may not be limited to single-graft cases.
