Complete Coronary Revascularization via Left Anterior Thoracotomy

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Procedures
• Cardiac Surgery Techniques

Background:

• Conventional coronary artery bypass grafting (CABG) involves sternotomy, carrying risks and longer recovery.
• Minimally invasive techniques aim to reduce surgical trauma and improve patient outcomes.
• Developing a reproducible, effective, and safe minimally invasive CABG is crucial for broader application.

Purpose of the Study:

• To develop and evaluate a minimally invasive on-pump multivessel CABG technique.
• To assess the safety and efficacy of this technique compared to conventional CABG.
• To determine the applicability of the technique across a wide patient population.

Main Methods:

• 170 consecutive patients underwent minimally invasive CABG via left anterior minithoracotomy.
• The procedure utilized on-pump multivessel grafting with blood cardioplegia.
• Grafting included arterial and venous conduits, with Left Internal Mammary Artery used in 93.5% of cases.

Main Results:

• Zero mortality, postoperative myocardial infarcts, or conversion to sternotomy.
• Low incidence of complications: 2 strokes (no residual deficit), 2 bleeding revisions.
• Efficient procedure times and short hospital stays (mean 6.3 days).

Conclusions:

• Complete coronary revascularization is achievable with this minimally invasive technique.
• The technique is suitable for the vast majority of patients with isolated coronary artery disease.
• No specific patient selection criteria are required, indicating broad applicability.