CARDIOVASCULAR
ENGINEERING
Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
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CARDIOVASCULAR
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Volume 3, 1998, No 1 |
Abstract:
Conventional cardiopulmonary bypass has become widely used for
coronary artery bypass surgery. It is safe and effective.
However, its damaging effects such as whole body inflammatory
response, complications from blood transfusion caused by
coagulopathy, plus the higher cost, longer intensive care unit
and hospital stay and limited medical budget are all matters with
cannot be ignored. Recently, we applied minimally invasive direct
coronary artery bypass (MIDCAB) surgery on the beating heart
without cardiopulmonary bypass for single-or double-vessel
coronary artery disease patients. 10 patients with symptomatic
coronary artery disease were included in this study. These
patients underwent attempted MIDCAB surgery. A left anterior
small thoracotomy (LAST) incision, about 8 cm long, was made in
the fourth intercostal space. The 4th intercostal cartilage was
excised (3rd cartilage also if needed). Left Internal mammary
artery (LIMA) was mobilized for about 6 cm long under direct
vision. End to side, LIMA to LAD anastomosis was performed for
seven patients with single vessel LAD disease and median
sternotomy for double-vessel disease with vein graft for one
patient. These 8 patients all underwent MIDCAB on beating hearts
without cardiopulmonary bypass. Among them, two patients, were
converted to traditional approach median sterotomy with
cardiopulmonary bypass for intramyocardial and calcified LAD,
respectively.
Keywords:
left anterior small thoracotomy, cardiopulmonary bypass, coronary
artery bypass graft, internal mammary artery
Address for Correspondence:
Reference:
(CVE. 1998; 3 (1): 3-5)
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