ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Minimally Invasive Direct Myocardial Revascularization
Şenol YAVUZ, Mustafa MAVİ, Tahsin BOZAT, M. Adnan CELKAN, A. Hakan VURAL, İ. Ayhan ÖZDEMİR
Bursa Yüksek İhtisas Hastanesi Göğüs Kalp Damar Cerrahi Kliniği, Bursa

Currently, recent efforts in myocardial revascularization focused on less invasive surgical approach Less-invasive surgery brings quiker recovery. Anastomosis of the left internal mammary artery (LIMA) to the left anterior descending coronary arter (LAD) through a limited left anterior thoracotomy reduces morbidity, hospital stay, and costs. From February 1996 to September 1996, 51 patients underwent a limited left anterior thoracotomy for single-vessel coronary artery (LAD) grafting on a beating heart. There were 42 (82%) men and 9 (18%) women with a mean age 65.8±6.3 years, ranging from 42 to 83 years. Mean ejection fraction was 52.3±7.8%. A small (6-10 cm) left anterior thoracotomy incision was made from near the nipple to the sternum over the anterior part of the fourth rib with excision of the fourth costal cartilage. Under direct vision, we performed bypass of the LAD with a LIMA through a left small (6-10 cm) anterior thoracotomy and without cardiopulmonary bypass. There was no inhospital mortality. Postoperative morbidity included superficial wound infection in 2 patients. No patient was reexplored for hemorrhage. A patient required blood products. 21 (41.2 %) patients underwent repeat coronary angiography, and all grafts were patient. Mean operativi time 1.75±0.5 hours. 41 (82.3 %) patients were discharged home 3-5 days postoperatively. All patients were alive and well at mean follow-up 3.5 months. Minimally invasive coronary artery bypass surgery for LAD revascularization with a LIMA is a simple, effective, and alternative therapeutic option to stan-dard CABG operation and PTCA for selected patients.

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