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Video assisted coronary bypass surgery

F J Benetti1, C Ballester, G Sani

  • 1Benetti Foundation, Buenos Aires, Argentina.

Journal of Cardiac Surgery
|November 1, 1995
PubMed
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This study presents a minimally invasive technique for coronary artery bypass grafting using arterial conduits without cardiopulmonary bypass. The novel approach demonstrated no perioperative mortality or myocardial infarction in 30 patients.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Cardiac Surgery
  • Vascular Grafting

Background:

  • Coronary artery disease necessitates revascularization procedures.
  • Traditional bypass surgery often involves extracorporeal circulation, posing certain risks.
  • Alternative arterial conduits offer potential benefits for myocardial revascularization.

Purpose of the Study:

  • To describe and evaluate an alternative method for coronary artery revascularization.
  • To assess the feasibility and outcomes of arterial grafting without extracorporeal circulation.
  • To explore the use of internal mammary arteries and gastroepiploic artery for bypass.

Main Methods:

  • A minimally invasive thoracotomy approach was used to harvest the left internal mammary artery (LIMA).

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  • The right internal mammary artery and gastroepiploic artery were utilized in selected cases.
  • Coronary revascularization was performed without the use of cardiopulmonary bypass.
  • Thirty patients underwent this procedure between April 1994 and June 1995.

    • Main Results:

    • All 30 patients received a LIMA graft to the left anterior descending artery.
    • Two patients received an additional free radial artery graft from the LIMA.
    • No perioperative mortality or myocardial infarction was observed.
    • Angiographic studies before discharge showed successful graft patency.
    • The average hospital stay was 43 +/- 11 hours.

    Conclusions:

    • Arterial conduits can be effectively used for coronary revascularization without extracorporeal circulation.
    • This minimally invasive technique offers a safe and potentially beneficial alternative for select patients.
    • The study highlights the successful application of LIMA, right internal mammary artery, and gastroepiploic artery grafts.