Abstract
Interest in minimally invasive coronary artery bypass grafting (MICABG) on the beating heart is growing. The premise for adopting these less invasive approaches is that patient morbidity can be reduced without compromising the safety and efficacy of conventional CABG. Despite the encouraging early clinical results reported by Benetti (1), Buffolo (2), Pfister (3), Subramanian (4), Calafiore (5), and their associates, CABG without cardiopulmonary bypass (CPB) via midline sternotomy or minithoracotomy has met with concerns of technical limitations and efficacy of anastomosis (6–8). Recently, the introduction of surgical instrumentation to facilitate internal mammary artery (IMA) harvest, mechanical local immobilization and stabilization of coronary artery target sites has enabled standardization of the surgical technique for left internal mammary artery to left anterior descending (LIMA-LAD) anastomosis by a minimally invasive direct coronary artery bypass (MIDCAB) approach, with predictable good results.
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References
Benetti FJ, Naselli G, Wood M, Gefner L. Direct myocardial revascularization without extracorporeal circulation. Chest 1991; 100: 312–316.
Buffolo E, de Andrade JCS, Branco JNR, Teles CA, Aguiar LF, Gomes WJ. Coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg 1996; 61: 63–66.
Pfister AJ, Zaki MS, Garcia JM, et al. Coronary artery bypass without cardiopulmonary bypass. Ann Thorac Surg 1992; 54: 1085–1091.
Subramanian VA, Sani G, Benetti FJ, Calafiore AM. Minimally invasive coronary bypass surgery: a multicenter report of preliminary clinical experience. Circulation 1995;(Suppl 8) 92: S 1645.
Calafiore AM, DiGiammarco G, Teodori G, et al. Left anterior descending coronary artery grafting via left anterior small thoracotomy without cardiopulmonary bypass. Ann Thorac Surg 1996; 61: 1658–1665.
Lytle BW. Minimally invasive cardiac surgery. J Thorac Cardiovasc Surg 1996; 111: 554, 555.
Ullyot DJ. Look ma, no hands! Ann Thorac Surg 1996; 61: 10–11.
Gundry SR. Discussion of Pfister AJ, Zaki MS, Garcia JM, et al. Coronary artery bypass without cardiopulmonary bypass. Ann Thorac Surg 1992; 54: 1091–1092.
Howie MB, Hiestand DC, Jopling MW, Romanelli VA, Kelly WB, McSweeney TD. Effect of oral clonidine premedication on anesthetic requirement, hormonal response, hemodynamics, and recovery in coronary artery bypass graft surgery patients. J Clin Anesth 1996; 8 (4): 263–272.
Suma H. Optimal use of the gastroepiploic artery. Semin Thorac Cardiovasc Surg 1996; 8 (1): 24–28.
Nataf P, Lima L, Regan M, et al. Thoracoscopic internal mammary harvesting: technical considerations. Ann Thorac Surg 1997;(Suppl)63:S104—S106.
Ohtsuka T, Wolf RK, Hiratzka LF, Wurnig P, Flege JB. Thoracoscopic internal mammary artery harvest for MICABG using the harmonic scalpel. Ann Thorac Surg 1997; 63: S107 — S109.
Subramanian VA. Less invasive arterial CABG on a beating heart. Ann Thorac Surg 1997; 63: S68 — S71.
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Subramanian, V.A. (1999). Minimally Invasive Coronary Artery Bypass Grafting on the Beating Heart. In: Oz, M.C., Goldstein, D.J. (eds) Minimally Invasive Cardiac Surgery. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4757-3036-4_8
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DOI: https://doi.org/10.1007/978-1-4757-3036-4_8
Publisher Name: Humana Press, Totowa, NJ
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