| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1998;66:1022-1025
© 1998 The Society of Thoracic Surgeons
a Clinic of Cardiac Surgery, Heartcenter, University of Leipzig, Leipzig, Germany
Address reprint requests to Dr Diegeler, Clinic of Heart Surgery, Heartcenter, University of Leipzig, Russenstr 19, D 04289 Leipzig, Germany
e-mail: (diea{at}server3.medizin.uni-leipzig.de)
Presented at "Facts and Myths of Minimally Invasive Cardiac Surgery: Current Trends in Thoracic Surgery IV," New Orleans, LA, Jan 24, 1998.
Abstract
Background. There is renewed interest in coronary artery bypass grafting without cardiopulmonary bypass using the anterolateral minithoracotomy approach. We evaluated 209 patients who underwent minimally invasive direct coronary artery bypass grafting using an anterolateral minithoracotomy. The anastomosis was performed under direct vision on the beating heart without using cardiopulmonary bypass.
Methods. The procedure was performed using a 6- to 9-cm left (or right) anterolateral thoracotomy for internal thoracic artery graft harvesting and anastomosis. Different devices were used for local immobilization. In 195 patients a single internal thoracic artery to left anterior descending coronary artery bypass was performed, in 3 patients a single right internal thoracic artery to right coronary artery bypass, and in 11 patients the radial artery was used together with the internal thoracic artery as a T-graft.
Results. Conversion to sternotomy or cardiopulmonary bypass was necessary in 10 (4.7%) patients. Intraoperative myocardial infarction was observed in 4 patients (1.9%). Early postoperative redo operation was necessary in 5 patients (2.4%). Mortality was 0.47%. Postoperatively, 191 patients (91.3%) underwent angiography for graft patency control. The overall patency rate was 97.3%. Minor stenosis of the internal thoracic artery graft was observed in 18 patients (9.4%); moderate stenosis was observed in 5 patients (2.6%). Midterm angiographic follow-up after 6 months was performed in 58 patients. The patency rate was 98.2%. One patient with severe symptomatic stenosis (1.7%) underwent reoperation.
Conclusions. With the help of the local immobilization systems off-pump coronary artery bypass grafting was safely performed through a minithoracotomy. The incidence of intraoperative and postoperative complications was low and follow-up showed good results. Thus, minimally invasive direct coronary artery bypass grafting is an excellent technique for arterial revascularization in patients having symptomatic left anterior descending coronary artery disease.
This article has been cited by other articles:
|
|
 |
|
  H. Thiele, P. Neumann-Schniedewind, S. Jacobs, E. Boudriot, T. Walther, F.-W. Mohr, G. Schuler, and V. Falk Randomized Comparison of Minimally Invasive Direct Coronary Artery Bypass Surgery Versus Sirolimus-Eluting Stenting in Isolated Proximal Left Anterior Descending Coronary Artery Stenosis J. Am. Coll. Cardiol., June 23, 2009; 53(25): 2324 - 2331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Ben-Gal, R. Mohr, R. Braunstein, A. Finkelstein, N. Hansson, A. Hendler, Y. Moshkovitz, and G. Uretzky Revascularization of Left Anterior Descending Artery With Drug-Eluting Stents: Comparison With Minimally Invasive Direct Coronary Artery Bypass Surgery Ann. Thorac. Surg., December 1, 2006; 82(6): 2067 - 2071. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Di Giammarco, M. Pano, S. Cirmeni, P. Pelini, G. Vitolla, and M. Di Mauro Predictive value of intraoperative transit-time flow measurement for short-term graft patency in coronary surgery. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 468 - 474. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Raja Drug-Eluting Stents and the Future of Coronary Artery Bypass Surgery: Facts and Fiction Ann. Thorac. Surg., March 1, 2006; 81(3): 1162 - 1171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Thiele, S. Oettel, S. Jacobs, R. Hambrecht, P. Sick, J. F. Gummert, F. W. Mohr, G. Schuler, and V. Falk Comparison of Bare-Metal Stenting With Minimally Invasive Bypass Surgery for Stenosis of the Left Anterior Descending Coronary Artery: A 5-Year Follow-Up Circulation, November 29, 2005; 112(22): 3445 - 3450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Jacobs, D. Holzhey, T. Walther, V. Falk, and F. W. Mohr Redo Minimally Invasive Direct Coronary Artery Bypass Grafting Ann. Thorac. Surg., October 1, 2005; 80(4): 1336 - 1339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K.H. Leong, V. Ashok, A. Nishkantha, Y. H. Shan, and E. K.W. Sim Transit-Time Flow Measurement is Essential in Coronary Artery Bypass Grafting Ann. Thorac. Surg., March 1, 2005; 79(3): 854 - 857. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Farhat, S. Aubert, P. Blanc, and O. Jegaden Totally endoscopic off-pump bilateral internal thoracic artery bypass grafting Eur. J. Cardiothorac. Surg., October 1, 2004; 26(4): 845 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Jacobs, D. Holzhey, B. B. Kiaii, J. F. Onnasch, T. Walther, F. W. Mohr, and V. Falk Limitations for manual and telemanipulator-assisted motion tracking--implications for endoscopic beating-heart surgery Ann. Thorac. Surg., December 1, 2003; 76(6): 2029 - 2035. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Diegeler, H. Thiele, V. Falk, R. Hambrecht, N. Spyrantis, P. Sick, K. W. Diederich, F. W. Mohr, and G. Schuler Comparison of Stenting with Minimally Invasive Bypass Surgery for Stenosis of the Left Anterior Descending Coronary Artery N. Engl. J. Med., August 22, 2002; 347(8): 561 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Falk Manual control and tracking--a human factor analysis relevant for beating heart surgery Ann. Thorac. Surg., August 1, 2002; 74(2): 624 - 628. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Drenth, J. B. Winter, N. J. G. M. Veeger, S. H. J. Monnink, A. J. van Boven, J. G. Grandjean, M. A. Mariani, and P. W. Boonstra Minimally invasive coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty with stenting in isolated high-grade stenosis of the proximal left anterior descending coronary artery: Six months' angiographic and clinical follow-up of a prospective randomized study J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 130 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bucerius, S. Metz, T. Walther, V. Falk, N. Doll, F. Noack, D. Holzhey, A. Diegeler, and F. W. Mohr Endoscopic internal thoracic artery dissection leads to significant reduction of pain after minimally invasive direct coronary artery bypass graft surgery Ann. Thorac. Surg., April 1, 2002; 73(4): 1180 - 1184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Oliveira, L. A. F. Lisboa, L. A. O. Dallan, S. O. Rojas, and L. F. Poli de Figueiredo Minimally invasive single-vessel coronary artery bypass with the internal thoracic artery and early postoperative angiography: midterm results of a prospective study in 120 consecutive patients Ann. Thorac. Surg., February 1, 2002; 73(2): 505 - 510. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Groom, J. Tryzelaar, R. Forest, K. Niimi, G. Cecere, D. Donegan, S. Katz, P. Weldner, R. Quinn, J. Braxton, et al. Intra-operative quality assessment of coronary artery bypass grafts Perfusion, December 1, 2001; 16(6): 511 - 518. [Abstract] [PDF]
|
|
|
|
|
|
H. Corbineau, J.-P. Verhoye, T. Langanay, P. Menestret, and A. Leguerrier Feasibility of the utilisation of the right internal thoracic artery in the transverse sinus in off pump coronary revascularisation: early angiographic results Eur. J. Cardiothorac. Surg., November 1, 2001; 20(5): 918 - 922. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Detter, H. Reichenspurner, D. H. Boehm, M. Thalhammer, A. Schutz, and B. Reichart Single vessel revascularization with beating heart techniques - minithoracotomy or sternotomy? Eur. J. Cardiothorac. Surg., April 1, 2001; 19(4): 464 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Bowles, J. D. Lee, C. R. Dang, S. N. Taoka, E. W. Johnson, E. M. Lau, and K. Nekomoto Coronary Artery Bypass Performed Without the Use of Cardiopulmonary Bypass Is Associated With Reduced Cerebral Microemboli and Improved Clinical Results Chest, January 1, 2001; 119(1): 25 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Mehran, G. Dangas, S. C. Stamou, A. J. Pfister, M. K. C. Dullum, M. B. Leon, and P. J. Corso One-Year Clinical Outcome After Minimally Invasive Direct Coronary Artery Bypass Circulation, December 5, 2000; 102(23): 2799 - 2802. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bucerius, S. Metz, T. Walther, N. Doll, V. Falk, A. Diegeler, R. Autschbach, and F. W. Mohr Pain is significantly reduced by cryoablation therapy in patients with lateral minithoracotomy Ann. Thorac. Surg., September 1, 2000; 70(3): 1100 - 1104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Biglioli, C. Antona, F. Alamanni, A. Parolari, T. Toscano, G. Pompilio, and G. Polvani Minimally invasive direct coronary artery bypass grafting: midterm results and quality of life Ann. Thorac. Surg., August 1, 2000; 70(2): 456 - 460. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
O. Godje, C. Thiel, P. Lamm, H. Reichenspurner, C. Schmitz, A. Schutz, and B. Reichart Less invasive, continuous hemodynamic monitoring during minimally invasive coronary surgery Ann. Thorac. Surg., October 1, 1999; 68(4): 1532 - 1536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 M. S. Ghotbi and J. G. Ramsay Minimally Invasive Cardiac Surgery: Impact on Resource Usage, Costs, Length of Stay, and Return to Function Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1999; 3(2): 126 - 135. [Abstract] [PDF]
|
|
|
|
|
|
T. M. McLoitghlin JR Complications of Minimally Invasive Cardiac Surgical Procedures Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1999; 3(2): 136 - 142. [Abstract] [PDF]
|
|
|
|
|
|
C. Borst and P. F. Grundeman Minimally Invasive Coronary Artery Bypass Grafting : An Experimental Perspective Circulation, March 23, 1999; 99(11): 1400 - 1403. [Full Text] [PDF]
|
|
|
|
|
|
P. P. McKeown Minimally invasive cardiac surgery. Ann. Thorac. Surg., February 1, 1999; 67(2): 600 - 601. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
