Bilateral MIDCAB for triple vessel coronary disease

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Minimally invasive direct coronary artery bypass grafting (MIDCAB) via anterior mini-thoracotomy traditionally targets single or double vessel coronary disease.
• Percutaneous coronary intervention (PCI) has reduced the application of MIDCAB.
• MIDCAB avoids sternotomy, benefiting patients at high risk for sternal wound complications.

Purpose of the Study:

• To describe a modified bilateral anterior mini-thoracotomy approach for minimally invasive direct coronary artery bypass grafting.
• To evaluate the feasibility of using bilateral internal mammary arteries and radial artery conduits with an aortic no-touch technique in off-pump surgery.

Main Methods:

• The study involved two patients undergoing coronary artery bypass grafting.
• A bilateral anterior mini-thoracotomy approach was employed.
• Bilateral internal mammary arteries and radial artery conduits were utilized for an aortic no-touch, off-pump technique.

Main Results:

• The described surgical technique was successfully applied in two patients.
• The bilateral anterior mini-thoracotomy approach allowed for the use of multiple arterial conduits.
• An aortic no-touch technique was achieved during off-pump surgery.

Conclusions:

• Bilateral anterior mini-thoracotomy is a feasible approach for minimally invasive direct coronary artery bypass grafting.
• This technique enables the use of bilateral internal mammary and radial artery grafts with an aortic no-touch strategy.
• It offers a valuable sternotomy-sparing option for selected patients with complex coronary artery disease.