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Ann Thorac Surg 1996;61:1658-1663
© 1996 The Society of Thoracic Surgeons
Departments of Cardiac Surgery, Anesthesia, and Cardiology, "G. D'Annunzio" Chieti University, Chieti, Italy
Background. We explored the possibility of anastomosing the left internal mammary artery (LIMA) to the left anterior descending artery in a beating heart via a left anterior small thoracotomy.
Methods. This procedure was performed in 155 of 162 scheduled patients; in 7 (4.3%) the left anterior descending artery was not suitable or was too small. The chest was opened in the fourth intercostal space (mean wound length, 10.5 cm) and the LIMA was harvested for about 4 cm. The left anterior descending artery was occluded by means of two 4/0 Prolene (Ethicon, Somerville, NJ) sutures, and the proximal suture was snared. The anastomosis was performed with two 8/0 Prolene sutures while the heart was beating. Early postoperatively all patients underwent repeat angiography or a Doppler flow assessment of the LIMA or both.
Results. The LIMA was connected directly to the left anterior descending artery in 144 patients and with interposition of an inferior epigastric artery in 11. In 2 patients the diagonal branch was also grafted using an inferior epigastric artery from the LIMA. One patient (0.6%) died 38 days after the operation due to multiorgan failure. Nine patients (5.8%) had failure requiring a redo operation: 7 (4.5%) early and 2 (1.3%) late. One additional patient had a late percutaneous transluminal coronary angioplasty for anastomotic stenosis. At a mean 5.6 months of follow-up, 143 patients (92.2%) were alive, asymptomatic with or without medical treatment, and without cardiac events.
Conclusions. Left internal mammary artery-to-left anterior descending artery anastomosis performed on a beating heart via a left anterior small thoracotomy is a safe procedure. In selected patients the operation has good early and midterm results.
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Ann. Thorac. Surg. 1996 61: 1664-1665.
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M. Ricci, H. L. Karamanoukian, R. Abraham, K. Von Fricken, G. D'Ancona, S. Choi, J. Bergsland, and T. A. Salerno Stroke in octogenarians undergoing coronary artery surgery with and without cardiopulmonary bypass Ann. Thorac. Surg., May 1, 2000; 69(5): 1471 - 1475. [Abstract] [Full Text] [PDF]
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V. A. Subramanian and N. U. Patel Transabdominal mimially invasive direct coronary artery bypass grafting (MIDCAB) Eur. J. Cardiothorac. Surg., April 1, 2000; 17(4): 485 - 487. [Abstract] [Full Text] [PDF]
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A. Bhan, S. K. Choudhary, A. Mathur, R. Sharma, M. Sahoo, R. Agrawal, and P. Venugopal Surgical myocardial revascularization without cardiopulmonary bypass Ann. Thorac. Surg., April 1, 2000; 69(4): 1216 - 1221. [Abstract] [Full Text] [PDF]
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A. Lichtenberg, U. Klima, W. Harringer, P. Y. Kim, and A. Haverich Mini-sternotomy for off-pump coronary artery bypass grafting Ann. Thorac. Surg., April 1, 2000; 69(4): 1276 - 1277. [Abstract] [Full Text] [PDF]
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M. J. Mack Reply Ann. Thorac. Surg., March 1, 2000; 69(3): 979 - 980. [Full Text] [PDF]
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L. Wiklund, M. Johansson, G. Brandrup-Wognsen, M. Bugge, G. Radberg, and E. Berglin Difficulties in the interpretation of coronary angiogram early after coronary artery bypass surgery on the beating heart Eur. J. Cardiothorac. Surg., January 1, 2000; 17(1): 46 - 51. [Abstract] [Full Text] [PDF]
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R. J. Damiano Jr, W. J. Ehrman, C. T. Ducko, H. A. Tabaie, E. R. Stephenson Jr, C. P. Kingsley, and C. E. Chambers INITIAL UNITED STATES CLINICAL TRIAL OF ROBOTICALLY ASSISTED ENDOSCOPIC CORONARY ARTERY BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., January 1, 2000; 119(1): 77 - 82. [Abstract] [Full Text] [PDF]
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H. S. Bedi, A. Suri, M. S. Kalkat, B. S. Sengar, V. Mahajan, R. Chawla, and V. P. Sharma Global myocardial revascularization without cardiopulmonary bypass using innovative techniques for myocardial stabilization and perfusion Ann. Thorac. Surg., January 1, 2000; 69(1): 156 - 164. [Abstract] [Full Text] [PDF]
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 T Wittwer, J Cremer, P Boonstra, J Grandjean, M Mariani, A Mugge, H Drexler, P den Heijer, E-R v Leitner, A Hepp, et al. Myocardial "hybrid" revascularisation with minimally invasive direct coronary artery bypass grafting combined with coronary angioplasty: preliminary results of a multicentre study Heart, January 1, 2000; 83(1): 58 - 63. [Abstract] [Full Text] [PDF]
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M. F. Szwerc, D. H. Benckart, R. J. Wiechmann, E. B. Savage, G. W. Szydlowski, G. J. Magovern Jr, and J. A. Magovern Partial versus full sternotomy for aortic valve replacement Ann. Thorac. Surg., December 1, 1999; 68(6): 2209 - 2213. [Abstract] [Full Text] [PDF]
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M. Ono, S. Takamoto, and T. Ohtsuka Right ventricular rupture in minimally invasive direct coronary artery bypass grafting Eur. J. Cardiothorac. Surg., November 1, 1999; 14(5): 536 - 537. [Abstract] [Full Text] [PDF]
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A. M. Calafiore, M. Contini, A. L. Iaco, N. Maddestra, L. Paloscia, T. Iovino, and M. Di Mauro Angiographic anatomy of the grafted left internal mammary artery Ann. Thorac. Surg., November 1, 1999; 68(5): 1636 - 1639. [Abstract] [Full Text] [PDF]
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U. Kappert, V. Gulielmos, M. Knaut, R. Cichon, J. Schneider, and S. Schueler The application of the Octopus(R) stabilizing system for the treatment of high risk patients with coronary artery disease Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S7 - S9. [Abstract] [Full Text] [PDF]
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J. D Fonger Integrated myocardial revascularization Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S12 - S17. [Abstract] [Full Text] [PDF]
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R. D. L. Stanbridge and L. K. Hadjinikolaou Technical adjuncts in beating heart surgery Comparison of MIDCAB to off-pump sternotomy: a meta-analysis Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S24 - S33. [Abstract] [Full Text] [PDF]
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G. Wimmer-Greinecker, G. Matheis, S. Dogan, T. Aybek, S. Mierdl, P. Kessler, and A. Moritz Patient selection for Port-AccessTM multi vessel revascularization Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S43 - S47. [Abstract] [Full Text] [PDF]
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V. Gulielmos, M. Brandt, H.-M. Dill, M. Knaut, R. Cichon, K. Matschke, and S. Schueler Coronary artery bypass grafting via median sternotomy or lateral minithoracotomy Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S48 - S52. [Abstract] [Full Text] [PDF]
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A. Pavie, L. Lima, N. Bonnet, M. Regan, R. Aktar, and I. Gandjbakhch Perioperative management in minimally invasive coronary surgery Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S53 - S57. [Abstract] [Full Text] [PDF]
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A. Diegeler, M. Matin, V. Falk, C. Binner, T. Walther, R. Autschbach, and F.-W. Mohr Quality assessment in minimally invasive coronary artery bypass grafting Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S67 - S72. [Abstract] [Full Text] [PDF]
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V. Gulielmos, M. Knaut, R. Cichon, K. Matschke, U. Kappert, M. Brandt, J. Hoffmann, and S. Schueler Experiences with a minimally invasive surgical technique for the treatment of coronary artery multivessel disease in 100 patients Eur. J. Cardiothorac. Surg., October 1, 1999; 14(4): 347 - 352. [Abstract] [Full Text] [PDF]
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A. A. Pitsis and G.D. Angelini Off pump coronary bypass grafting of the circumflex artery Eur. J. Cardiothorac. Surg., October 1, 1999; 16(4): 478 - 479. [Abstract] [Full Text] [PDF]
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R. De Paulis, F. Tomai, A. Gaspardone, L. Colagrande, P. Nardi, A. Ghini, F. Versaci, A. P. de Peppo, P. A. Gioffre, and L. Chiariello CORONARY FLOW RESERVE EARLY AND LATE AFTER MINIMALLY INVASIVE CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH TOTALLY OCCLUDED LEFT ANTERIOR DESCENDING CORONARY ARTERY J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 604 - 609. [Abstract] [Full Text] [PDF]
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T. Wittwer, J. Cremer, U. Klima, T. Wahlers, and A. Haverich Myocardial "hybrid" revascularization: Intermediate results of an alternative approach to multivessel coronary artery disease J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 766 - 767. [Full Text]
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T. H. Spooner, J. C. Hart, and J. Pym A two-year, three institution experience with the Medtronic Octopus: systematic off-pump surgery Ann. Thorac. Surg., October 1, 1999; 68(4): 1478 - 1481. [Abstract] [Full Text] [PDF]
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V. Gulielmos, M. Brandt, M. Knaut, R. Cichon, F. M. Wagner, U. Kappert, and S. Schuler The Dresden approach for complete multivessel revascularization Ann. Thorac. Surg., October 1, 1999; 68(4): 1502 - 1505. [Abstract] [Full Text] [PDF]
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E. R. Stephenson Jr, C. T. Ducko, S. Sankholkar, E. M. Hoenicke, G. A. Prophet, and R. J. Damiano Jr Computer-assisted endoscopic coronary artery bypass anastomoses: a chronic animal study Ann. Thorac. Surg., September 1, 1999; 68(3): 838 - 843. [Abstract] [Full Text] [PDF]
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C. T. Lloyd, A. M. Calafiore, P. Wilde, R. Ascione, L. Paloscia, C. R. Monk, and G. D. Angelini Integrated left anterior small thoracotomy and angioplasty for coronary artery revascularization Ann. Thorac. Surg., September 1, 1999; 68(3): 908 - 911. [Abstract] [Full Text] [PDF]
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S. Yavuz, M A. Celkan, C. Eris, M. Mavi, T. Turk, O. Tiryakioglu, Y. Ata, V. Koca, and I A. Ozdemir Minimally Invasive Coronary Artery Bypass: Experience in 114 Patients Asian Cardiovasc Thorac Ann, September 1, 1999; 7(3): 177 - 181. [Abstract] [Full Text] [PDF]
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A Diegeler, M Matin, V Falk, C. Binner, T. Walther, R Autschbach, and F.W Mohr Indication and patient selection in minimally invasive and 'off-pump' coronary artery bypass grafting Eur. J. Cardiothorac. Surg., September 1, 1999; 16(suppl_1): S79 - S82. [Abstract] [Full Text] [PDF]
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J. Pym Off-pump arterial grafting: 125 cases using the Medtronic-Utrecht Octopus Eur. J. Cardiothorac. Surg., September 1, 1999; 16(suppl_1): S88 - S94. [Abstract] [Full Text] [PDF]
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