Document Detail


Initial experience with MIDCAB grafting using the gastroepiploic artery.
MedLine Citation:
PMID:  10475408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Minimally invasive direct coronary artery bypass grafting with the gastroepiploic artery can be used in primary operations and reoperations to revascularize the inferior or anterior surface of the heart. METHODS: Patients who had symptomatic coronary artery disease limited to a single coronary distribution were selected. Coronary targets were grafted with the pedicled gastroepiploic artery through a small midline epigastric incision. Patients were followed with scheduled outpatient clinic visits, Doppler examination, and selective recatheterization. RESULTS: Between May 1995 and November 1997, 74 patients underwent gastroepiploic artery minimally invasive direct coronary artery bypass grafting; 33 (45%) had a primary operation and 41 (55%), a reoperation. Grafting was performed to the distal right coronary artery (n = 38), the posterior descending artery (n = 28), or the distal left anterior descending coronary artery (n = 8). There were six deaths (8%) within 30 days after operation. Twenty patients (28%) underwent recatheterization; there were two graft occlusions, two graft stenoses, and five anastomotic stenoses. Of 60 patients seen 2 or more weeks after operation, 53 (88%) had resolution of anginal symptoms at a mean follow-up of 10.9 months (range, 0 to 30 months). CONCLUSIONS: Inferior minimally invasive direct coronary artery bypass grafting with the gastroepiploic artery avoids the risks of repeat sternotomy, aortic manipulation, and cardiopulmonary bypass. Patency rates, however, were lower than expected, and there is significant morbidity and mortality associated with high-risk patients undergoing the procedure. Continued follow-up is essential to evaluate long-term graft patency and patient survival.
Authors:
J D Fonger; J R Doty; J D Salazar; P L Walinsky; N W Salomon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  68     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-15     Completed Date:  1999-09-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  431-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiac Surgery, Sinai Hospital of Baltimore, Maryland, USA. jfonger@heartnet.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arteries / transplantation*
Coronary Artery Bypass*
Female
Follow-Up Studies
Graft Occlusion, Vascular / etiology,  surgery
Humans
Male
Middle Aged
Postoperative Complications / etiology,  surgery
Reoperation
Surgical Procedures, Minimally Invasive*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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