Left thoracotomy for reoperations in myocardium revascularization
Carlos Sérgio Luna Gomes Duarte1, Fernando Ribeiro de Moraes Neto, Carlos Roberto Ribeiro de Moraes
1Heart Institute of Pernambuco (Real Hospital Português de Beneficência em Pernambuco), Recife, PE, Brazil.
Insights
Off-pump redo coronary artery bypass surgery (CABG) via left thoracotomy offers a safe alternative to traditional sternotomy. This approach in selected patients resulted in no mortality and freedom from angina.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Reoperative coronary artery bypass grafting (redo-CABG) traditionally involves resternotomy, carrying significant risks.
- Exploring alternative surgical approaches is crucial for improving patient outcomes in redo-CABG procedures.
Observation:
- Eight patients underwent redo-CABG without cardiopulmonary bypass (CPB) via a left posterolateral thoracotomy.
- These patients required revascularization of the circumflex coronary artery system, with patent grafts to the anterior interventricular branch and/or right coronary artery.
Findings:
- The study reported no in-hospital mortality or serious postoperative complications.
- All patients were angina-free following the procedure.
Implications:
- Off-pump redo-CABG through a left thoracotomy may mitigate risks associated with resternotomy.
- This minimally invasive technique shows promise for carefully selected patients undergoing repeat bypass surgery.
Objective:
To describe patient selection criteria, surgical technique and early outcomes in patients undergoing reoperative coronary artery bypass surgery (RECABG) through a left thoracotomy without cardiopulmonary bypass (CPB).
Methods:
Eight patients with patent grafts to the anterior interventricular branch of left coronary artery (four of which had also patent grafts to the right coronary artery) requiring revascularization of the circumflex coronary system had redo-CABG without CPB through a left posterolateral thoracotomy.
Results:
There was no in-hospital mortality or serious postoperative complications. All patients are angina-free.
Conclusions:
An off-pump redo-CABG through a left posterolateral thoracotomy may reduce risks attributable to resternotomy in patients who met the selection criteria.
