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Ann Thorac Surg 1996;61:10-11
© 1996 The Society of Thoracic Surgeons

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Editorials

Look Ma, No Hands!

Cardiac Surgery, Peninsula Hospital, Burlingame, California

The first 20% of the full text of this article appears below.

From time to time the surgical orthodoxy is challenged by asserting less is more and by questioning the need to employ the full available technological armamentarium. A number of such challenges come to mind during the evolution of coronary artery bypass grafting.

Loop and colleagues [1] argued that one could perform internal mammary artery anastomoses to coronary vessels 1 mm or larger in diameter without resort to high-power magnification, addressing themselves to work by Bailey and Hirose [2] and Green and associates [3], who reported internal mammary artery grafting with 2.5x magnification (optical loupes) and 16x magnification (operating microscope), respectively. Akins [4] and Bonchek and Burlingame [5] independently published clinical series showing that good results in myocardial revascularization could be obtained without using cardioplegia. In the early 1970s Ankeney [6] advocated coronary bypass grafting to the right coronary artery and left anterior descending coronary artery in the beating heart without extracorporeal circulation. Although none of these reports made a rigorous argument using prospective, randomized trial methodology, all offered an appealing simplicity with good clinical results and were championed by respected surgeons.

See also 63.

In this issue of The Annals Buffolo and colleagues [7] revisit the subject of coronary artery bypass grafting without cardiopulmonary bypass (CPB). They operated on 1,274 consecutive, carefully selected patients (patients . . . [Full Text of this Article]

Related Article

Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass

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Ann. Thorac. Surg. 1996 61: 63-66. [Abstract] [Full Text]

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