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Related Experiment Videos

"Keyhole" coronary artery bypass surgery

R J Landreneau1, M J Mack, J A Magovern

  • 1Division of Cardiothoracic Surgery, Alleghany University of the Health Sciences, Medical College of Pennsylvania/Hahnemann University, Pittsburgh.

Annals of Surgery
|October 1, 1996
PubMed
Summary

Keyhole coronary artery bypass grafting (CABG) offers a minimally invasive option for single-vessel disease. Early results show it

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Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Techniques
  • Coronary Artery Disease Management

Background:

  • Minimally invasive surgery adoption in cardiac procedures has been slow.
  • Keyhole thoracotomy, a 6 cm incision, was explored for coronary artery bypass grafting (CABG).
  • Internal mammary artery (IMA) pedicle dissection was performed thoracoscopically or via the keyhole incision.

Purpose of the Study:

  • To evaluate the utility of keyhole thoracotomy for single-vessel coronary artery bypass surgery.
  • To assess the feasibility of IMA to LAD or RCA bypass grafting using this approach.

Main Methods:

  • Keyhole CABG was attempted in 49 patients with significant coronary artery obstruction unsuitable for endovascular treatment.
  • Procedures involved IMA pedicle dissection and bypass grafting to the LAD or RCA.

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  • Femoral cardiopulmonary bypass was utilized in 19% of successful cases; beta-blockade was common.

    • Main Results:

    • Successful keyhole CABG was achieved in 46 of 49 patients.
    • Average operative time was 248 minutes; median postoperative intubation was 6 hours.
    • Conversion to sternotomy occurred in 3 patients; complications included respiratory issues and wound infection. No perioperative infarctions occurred.

    Conclusions:

    • Early outcomes of keyhole CABG are promising for single-vessel coronary disease.
    • This technique may serve as an alternative to sternotomy or repeat interventions.
    • Further experience may establish keyhole CABG as a viable option for specific patient groups.