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Ann Thorac Surg 1996;61:135-137
© 1996 The Society of Thoracic Surgeons
Division of Cardiothoracic Surgery, Medical City Dallas Hospital, Dallas, Texas, and Division of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
Accepted for publication September 9, 1995.
Background. Standard options for the invasive management of proximal disease of the left anterior descending coronary artery include coronary artery bypass grafting with a left internal mammary artery and percutaneous transluminal coronary angioplasty.
Methods. We describe a surgical technique for bypass of the left anterior descending coronary artery with a left internal mammary artery without median sternotomy and without cardiopulmonary bypass. Thoracoscopy is used to harvest the internal mammary artery, whereas the mammary-coronary artery anastomosis is performed un-der direct vision through a limited anterior thoracotomy.
Results. We have performed this procedure successfully in 3 patients with minimal morbidity and shortened hospital stay. Average operative time was 3 hours and postoperative hospital stay averaged less than 48 hours.
Conclusions. Although experience is limited and follow-up is very short, with further experience, this less invasive surgical technique may become a viable option for the management of proximal left anterior descending disease.
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