Transxiphoid Revascularization of the Anterior Descending Coronary Artery with the Left Mammary Artery

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Procedures

Background:

• Coronary artery bypass grafting (CABG) via open sternotomy is a common procedure.
• Patients and clinicians seek alternatives to sternotomy for revascularization, particularly for left internal mammary artery (LIMA) to left anterior descending (LAD) artery bypass.

Purpose of the Study:

• To describe and evaluate a novel strictly transxiphoid mammary artery liberation with anastomosis to the anterior descending (TRAX CABG) technique.
• To assess the feasibility and success of TRAX CABG as a non-sternotomy alternative.

Main Methods:

• The study involved 26 patients undergoing attempted TRAX CABG.
• Eighteen patients successfully underwent non-sternotomy LIMA-to-LAD revascularization using the TRAX CABG technique.
• Completion angiography was performed to confirm bypass graft patency.

Main Results:

• Successful non-sternotomy LIMA-to-LAD revascularization was achieved in 18 out of 26 attempted TRAX CABG procedures.
• Conversion to traditional sternotomy was associated with limited unanticipated morbidity.
• Completion angiography confirmed the patency of the coronary artery bypass grafts.

Conclusions:

• TRAX CABG presents a viable, minimally invasive surgical option for LIMA-to-LAD revascularization in select patients.
• This technique avoids sternal division, potentially reducing surgical trauma and recovery time.
• The procedure demonstrates acceptable success rates with confirmation of bypass graft patency via angiography.