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[Minimally invasive coronary surgery. Thoracostomy-assisted thoracotomy. Apropos a case]
J I Aramendi1, J Pac, J Agredo
1Servicio de Cirugía Cardíaca y Torácica, Hospital de Cruces, Baracaldo.
Unlabelled:
CLINICAL CASE PRESENTATION: Male, 62 years old with progressive angina. Positive stress test. At catheterization a proximal 90% stenosis of the LAD was found. Not suitable for PTCA.
Surgical Technique:
Double lumen endotracheal tube was inserted. Position was 30 degrees right lateral decubitus. The thoracoscope was introduced through the 7th intercostal space and a minithoracotomy was done. The internal mammary artery (IMA) was dissected partially through direct vision and partially with the help of the thoracoscope. The IMA graft was implanted to the LAD without cardiopulmonary bypass with a segmentary occlusion of the vessel with tourniquets.
Evolution:
Thoracic drainage 575 cc, CK/MB 311/5, final hematocrit 37%. No blood transfusion. Dismissed on the 5th postoperative day.