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Total arterial multivessels minimal invasive direct coronary artery bypass grafting via left minithoracotomy

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Abstract

Background

Minimal Invasive Direct Coronary Artery Bypass Surgery (MIDCAB) is becoming popular and an important armamentarium for cardiac surgeons. We aimed to evaluate the result of MIDCAB total arterial revascularization.

Methods

We have evaluated 216 patients who underwent MIDCAB multivessel total arterial revascularization through a left anterolateral mini thoracotomy. LIMA harvested in every patient, RIMA or radial artery used as second conduit. LIMA-RIMA Y or LIMA-RADIAL Y was made to accomplish multivessels total arterial revascularization. Post-operative graft patency was evaluated in all patients by CT coronary angiography at 6 months following discharge.

Results

Mean age of patients was 52.5 ± 9.8 years. Average number of anastomosis performed were 2.34 ± 0.75. Multivessels total arterial CABG was accomplished in all individuals. There was no mortality or deep wound infection. Re-exploration was done in two patients for bleeding. In one patient emergency CPB was required. Average ICU and hospital stay was 1.52 ± 0.77 and 4.92 ± 1.46 days, respectively. Patients were mobilized earlier due to less pain. Wound healing of anterolateral thoracotomy was faster. In the follow up CT angiography 100% of the LIMA grafts were patent.

Conclusions

Multivessels total arterial MIDCAB can be accomplished safely in selected individuals. RIMA can be harvested in long standing diabetic patients with no concern for sternal wound healing. MIDCAB patients experience better cosmetics and early return to daily activities.

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Authors and Affiliations

  1. Department of Cardio Thoracic and Vascular Surgery, ADK Hospital Pvt. Ltd, Male, Maldives

    Kaushal K. Tiwari

  2. Department of Cardio Thoracic and Vascular Surgery, U.N.Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Asarwa, Ahmedabad, 380016, Gujarat, India

    Vivek Wadhawa, Manish Jawarkar, Divyesh Rathod, Mausam Shah, Pratik Manek & Chirag Doshi

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  1. Kaushal K. Tiwari
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  2. Vivek Wadhawa
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Correspondence to Vivek Wadhawa.

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Tiwari, K.K., Wadhawa, V., Jawarkar, M. et al. Total arterial multivessels minimal invasive direct coronary artery bypass grafting via left minithoracotomy. Gen Thorac Cardiovasc Surg 69, 8–13 (2021). https://doi.org/10.1007/s11748-020-01412-4

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  • DOI: https://doi.org/10.1007/s11748-020-01412-4

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