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The LAST operation: techniques and results before and after the stabilization era
A M Calafiore1, G Vitolla, V Mazzei
1Division of Cardiac Surgery, G. D'Annunzio University, Chieti, Italy. calafiore@unich.it
The Annals of Thoracic Surgery
|October 13, 1998
Summary
Specialized instrumentation improved outcomes for patients undergoing left internal mammary artery grafting via left anterior small thoracotomy. This technique enhances graft patency and event-free survival in beating heart surgery.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Left anterior descending artery stabilization enables left internal mammary artery grafting through a small thoracotomy on a beating heart.
- This study evaluates surgical outcomes with specialized instrumentation for this procedure.
Purpose of the Study:
- To assess if specialized instrumentation improves surgical results for left anterior small thoracotomy procedures.
- To compare outcomes between patients operated on before and after the introduction of specialized instruments.
Main Methods:
- Retrospective review of 261 patients undergoing left anterior small thoracotomy for single left anterior descending artery disease.
- Patients were divided into two groups: Group A (n=93) before specialized instrumentation and Group B (n=168) after.
Main Results:
- Graft patency rates were significantly higher in Group B (98.8%) compared to Group A (92.5%).
- Event-free survival at 19 months was higher in Group B.
- Early mortality and anastomotic malfunction rates were similar between groups.
Conclusions:
- Left anterior descending artery stabilization and improved left internal mammary artery harvesting techniques enhance angiographic and clinical results.
- Specialized instrumentation plays a key role in improving outcomes for minimally invasive coronary artery bypass grafting.