Minimally Invasive Direct Coronary Artery Bypass via Left Anterior Small Thoracotomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LINGYun-peng , BAOLi-ming , YANGWei , CHENYu

Department of Cardiac Surgery, Peking University People's Hospital, Beijing 100044, P. R. China;

Corresponding author：

LINGYun-peng, Email: yunpengling@sohu.com

Keywords：

Coronary artery bypass; Off-pump; Minimally invasive surgery

DOI：

10.7507/1007-4848.20150141

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the safety of a less traumatic surgical approach in minimally invasive direct coronary artery bypass (MIDCAB). Methods We retrospectively analyzed the clinical data of 70 patients underwent MIDCAB via left anterior small thoracotomy between May 2012 and August 2013. There were 60 male and 10 female patients with a mean age of 56.8±9.2 years (ranged 44-76 years), with single vessel disease (left anterior descending artery) in 42 patients,and double or three vessels disease in 28 patients (include left main vessel disease). Results The procedure were successfully completed in all 70 patients. No operation-related death or complication occurred. The extubation time was 4-16 (9.7±5.2) hours. The ICU time was 10-24(20.8±10.8)hours. They were followed up for 1-14 months. No deaths or angina or myocardial infarction occurred. Postoperative coronary angiography in 17 patients found no restenosis. Conclusion MIDCAB via left anterior small thoracotomy can be performed safely by using the new left internal mammary artery (LIMA) harvesting system.

Citation： LINGYun-peng, BAOLi-ming, YANGWei, CHENYu. Minimally Invasive Direct Coronary Artery Bypass via Left Anterior Small Thoracotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(6): 550-553. doi: 10.7507/1007-4848.20150141 Copy

1.	Kolessov VI. Mammary artery-coronary anastomosis as method of treatment for angina pectoris. J Thorac Cardiovasc Surg, 1967, 54(4): 535-544.
2.	Subramanian VA, Sani G, Bennetti FJ, et al. Minimally invasive direct coronary bypass surgery: mulitcenter report of preliminary clinical experience. Circulation, 1995, 92(suppl 1): 645.
3.	Benetti F, Mariani MA, Sani G, et al. Video-assisted minimally invasive coronary operations without cardiopulmonary bypass: a multicenter study. J Thorac Cardiovasc Surg, 1996, 112(6): 1478-1484.
4.	Mehran R, Subramanian V, Mack M, et al. Is the angiographic patency of LIMA-LAD anastomosis after MIDCAB equivalent to conventional CABG? Final results from the POEM trial. Circulation, 2001, 102: Ⅱ581.
5.	Holzhey DM, Jacobs S, Mochalski M, et al. Seven-year follow-up after minimally invasive direct coronary artery bypass: experience with more than 1300 patients. Ann Thorac Surg, 2007, 83(1): 108-114.
6.	Vassiliades TA Jr, Reddy VS, Puskas JD, et al. Long-term results of the endoscopic atraumatic coronary bypass. Ann Thorac Surg, 2007, 83(3): 979-985.
7.	Diegeler A, Thiele H, Falk V, et al. Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery. N Engl J Med, 2002, 347(8): 561-566.
8.	Drenth DJ, Veeger NJ, Winter JB, et al. A prospective randomized trial comparing stenting with off-pump coronary surgery for high-grade stenosis in the proximal left anterior descending coronary artery: three year follow-up. J Am Coll Cardiol, 2002, 40(11): 1955-1960.
9.	Jeffery Z, Kowlaski M, Weaver WD, et al. A meta-analysis of rando-mized control trials comparing minimally invasive direct coronary bypass grafting versus percutaneous coronary intervention for stenosis of the proximal left anterior descending artery. Eur J Cardio-thorac Surg, 2007, 31(4): 691-697.
10.	Etienne PY, D’hoorW, Papadatos S, et al. Five-year follow-up of drug-eluting stents implantation vs minimally invasive direct coro-nary artery bypass for left anterior descending artery disease: a propensity score analysis. Eur J Cardiothorac Surg, 2013, 44(5): 884-890.
11.	Kettereing K. Minimally invasive direct coronary artery bypass grafting: a mata-analysis. J Cardiovasc Surg, 2008, 49(6): 793-800.
12.	Hong SJ, Lim DS, Seo HS, et al. Percutaneous coronary intervention with drug-eluting stent implantation vs minimally invasive direct coronary artery bypass (MIDCAB) in patients with left anterior desending coronary artery stenosis. Catheter Cardiovasc Interv, 2005, 64(1): 75-81.
13.	Thiele H, Neumann-Schniedewind P, Jacobs S, et al. Randomized comparison of minimally invasive direct coronary bypass surgery versus sirolimus-eluting stenting in isolated proximal left anterior descending coronary stenosis. J Am Coll Cardiol, 2009, 53(25): 2324-2331.
14.	Goy JJ, Eeckhout E, Moret C, et al. Five-year outcome in patients with isolated proximal left anterior descending coronary artery stenosis treated by angioplasty or left internal mammary artery grafting. A prospective trial. Circulation, 1999, 99(25): 3255-3259.
15.	Berger PB, Alderman El, Nadel A, et al. Frequency of early occlusion and stenosis in a left intermal mammary artery to left anterior descending artery bypass graft after surgery through a median sternotomy on conventional bypass: benchmark for minimally invasive directive coronary artery bypass. Circulation, 1999, 100(23): 2353-2358.
16.	赵强, 王宜青, 夏利民, 等. 微创冠状动脉旁路术33例中期结果报告. 中国微创外科杂志, 2004, 4(3): 183-184.
17.	郑哲, 胡盛寿, 周玉燕. 电视胸腔镜辅助下微创冠状动脉旁路移植术临床及随访结果. 中华胸心血管外科杂志, 2006, 22(1): 52-53.
18.	王东进, 邵峻, 武忠, 等.经左胸前外侧小切口冠状动脉旁路移植术.中华外科杂志, 2009, 47(8): 574-576.
19.	Repossini A, Tespili M, Saino A, et al. Hybrid revascularization in multivessel coronary artery disease. Eur J Cardiothorac Surg, 2013, 44(2): 288-294.
20.	Halkos ME, Vassiliades TA, Douglas JS, et al. Hybrid coronary revascularization versus off-pump coronary artery bypass grafting for the treatment of multivessel coronary artery disease. Ann Thorac Surg, 2011, 92(5): 1695-1702.
21.	Halkos ME, Rab ST, Vassiliades TA, et al. Hybrid coronary revascu-larization versus off-pump coronary artery bypass for the treatment of left main coronary stenosis. Ann Thorac Surg, 2011, 92(6): 2155-2160.

1. Kolessov VI. Mammary artery-coronary anastomosis as method of treatment for angina pectoris. J Thorac Cardiovasc Surg, 1967, 54(4): 535-544.
2. Subramanian VA, Sani G, Bennetti FJ, et al. Minimally invasive direct coronary bypass surgery: mulitcenter report of preliminary clinical experience. Circulation, 1995, 92(suppl 1): 645.
3. Benetti F, Mariani MA, Sani G, et al. Video-assisted minimally invasive coronary operations without cardiopulmonary bypass: a multicenter study. J Thorac Cardiovasc Surg, 1996, 112(6): 1478-1484.
4. Mehran R, Subramanian V, Mack M, et al. Is the angiographic patency of LIMA-LAD anastomosis after MIDCAB equivalent to conventional CABG? Final results from the POEM trial. Circulation, 2001, 102: Ⅱ581.
5. Holzhey DM, Jacobs S, Mochalski M, et al. Seven-year follow-up after minimally invasive direct coronary artery bypass: experience with more than 1300 patients. Ann Thorac Surg, 2007, 83(1): 108-114.
6. Vassiliades TA Jr, Reddy VS, Puskas JD, et al. Long-term results of the endoscopic atraumatic coronary bypass. Ann Thorac Surg, 2007, 83(3): 979-985.
7. Diegeler A, Thiele H, Falk V, et al. Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery. N Engl J Med, 2002, 347(8): 561-566.
8. Drenth DJ, Veeger NJ, Winter JB, et al. A prospective randomized trial comparing stenting with off-pump coronary surgery for high-grade stenosis in the proximal left anterior descending coronary artery: three year follow-up. J Am Coll Cardiol, 2002, 40(11): 1955-1960.
9. Jeffery Z, Kowlaski M, Weaver WD, et al. A meta-analysis of rando-mized control trials comparing minimally invasive direct coronary bypass grafting versus percutaneous coronary intervention for stenosis of the proximal left anterior descending artery. Eur J Cardio-thorac Surg, 2007, 31(4): 691-697.
10. Etienne PY, D’hoorW, Papadatos S, et al. Five-year follow-up of drug-eluting stents implantation vs minimally invasive direct coro-nary artery bypass for left anterior descending artery disease: a propensity score analysis. Eur J Cardiothorac Surg, 2013, 44(5): 884-890.
11. Kettereing K. Minimally invasive direct coronary artery bypass grafting: a mata-analysis. J Cardiovasc Surg, 2008, 49(6): 793-800.
12. Hong SJ, Lim DS, Seo HS, et al. Percutaneous coronary intervention with drug-eluting stent implantation vs minimally invasive direct coronary artery bypass (MIDCAB) in patients with left anterior desending coronary artery stenosis. Catheter Cardiovasc Interv, 2005, 64(1): 75-81.
13. Thiele H, Neumann-Schniedewind P, Jacobs S, et al. Randomized comparison of minimally invasive direct coronary bypass surgery versus sirolimus-eluting stenting in isolated proximal left anterior descending coronary stenosis. J Am Coll Cardiol, 2009, 53(25): 2324-2331.
14. Goy JJ, Eeckhout E, Moret C, et al. Five-year outcome in patients with isolated proximal left anterior descending coronary artery stenosis treated by angioplasty or left internal mammary artery grafting. A prospective trial. Circulation, 1999, 99(25): 3255-3259.
15. Berger PB, Alderman El, Nadel A, et al. Frequency of early occlusion and stenosis in a left intermal mammary artery to left anterior descending artery bypass graft after surgery through a median sternotomy on conventional bypass: benchmark for minimally invasive directive coronary artery bypass. Circulation, 1999, 100(23): 2353-2358.
16. 赵强, 王宜青, 夏利民, 等. 微创冠状动脉旁路术33例中期结果报告. 中国微创外科杂志, 2004, 4(3): 183-184.
17. 郑哲, 胡盛寿, 周玉燕. 电视胸腔镜辅助下微创冠状动脉旁路移植术临床及随访结果. 中华胸心血管外科杂志, 2006, 22(1): 52-53.
18. 王东进, 邵峻, 武忠, 等.经左胸前外侧小切口冠状动脉旁路移植术.中华外科杂志, 2009, 47(8): 574-576.
19. Repossini A, Tespili M, Saino A, et al. Hybrid revascularization in multivessel coronary artery disease. Eur J Cardiothorac Surg, 2013, 44(2): 288-294.
20. Halkos ME, Vassiliades TA, Douglas JS, et al. Hybrid coronary revascularization versus off-pump coronary artery bypass grafting for the treatment of multivessel coronary artery disease. Ann Thorac Surg, 2011, 92(5): 1695-1702.
21. Halkos ME, Rab ST, Vassiliades TA, et al. Hybrid coronary revascu-larization versus off-pump coronary artery bypass for the treatment of left main coronary stenosis. Ann Thorac Surg, 2011, 92(6): 2155-2160.

Previous Article
肺大细胞神经内分泌癌六例临床分析
Next Article
Therapy Effect of Modified B-T Shunt for Complex Congenital Heart Disease

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Minimally Invasive Direct Coronary Artery Bypass via Left Anterior Small Thoracotomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content