| Multiple minimally invasive direct coronary artery bypass grafting for the complete revascularization of the left ventricle. | |
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MedLine Citation:
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PMID: 10421128 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Single-vessel coronary artery bypass grafting of the left internal mammary artery to the left anterior descending coronary artery using a minithoracotomy has been shown to produce excellent results with a very low mortality rate. However, this procedure cannot be used in patients with double- or triple-vessel disease. Our goal was to develop a minimally invasive direct coronary artery bypass grafting without cardiopulmonary bypass for total revascularization of the left ventricle using multiple arterial grafts. METHODS: Limited lateral thoracotomy was performed in the fourth or fifth intercostal spaces, exposing the left anterior descending coronary artery and left circumflex coronary artery. Two or three arterial grafts were harvested. Revascularization of the left anterior descending coronary artery and the left circumflex coronary artery were performed in 20 patients without cardiopulmonary bypass through the limited lateral thoracotomy using complex performed arterial grafts. In 4 patients, triple- and quadruple-vessel grafting was performed. RESULTS: The mean coronary cross-clamp time was 14.5+/-4.0 minutes for the left anterior descending coronary artery and 16.8+/-5.1 minutes for the left circumflex coronary artery. No early deaths or postoperative complications occurred. There were no late deaths or angina during the mean follow-up of 7.0 months (range, 2 to 22 months). Postoperative coronary angiography demonstrated widely patent grafts in all patients. CONCLUSIONS: Minimally invasive approach through a limited thoracotomy in multiple coronary artery bypass graftings are technically feasible and may be an alternative approach in the complete revascularization of the left ventricle. Mechanical immobilization of the coronary artery enhances early graft patency and is an essential part of this procedure. |
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Authors:
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G Watanabe; T Misaki; K Kotoh; K Kawakami; A Yamashita; K Ueyama |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 68 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-08-02 Completed Date: 1999-08-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 131-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Toyama Medical and Pharmaceutical University, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Coronary Angiography Coronary Artery Bypass / methods* Female Heart Ventricles Humans Male Middle Aged Postoperative Complications Surgical Procedures, Minimally Invasive |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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