Document Detail


Robotically enhanced minimally invasive direct coronary artery bypass surgery: a winning strategy?
MedLine Citation:
PMID:  17505438     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Minimally invasive direct coronary artery bypass (MIDCAB) through a small anterolateral thoracotomy on the beating heart can be considered as the better approach for treating isolated lesions on the left anterior descending (LAD) artery. This original MIDCAB procedure, however, involves a larger and often painful thoracotomy due to rib spreading. We describe our experience with robotically enhanced harvesting of one or both internal mammary arteries (IMAs), and with anastomosis performed under direct vision on a beating heart through a very small thoracotomy without rib retraction. METHODS: Between February 2001 and January 2006, 146 consecutive patients underwent robotically enhanced MIDCAB surgery. Perioperative and early follow-up data were analyzed. RESULTS: In all, 144 left and 13 right IMAs were harvested. The mean extubation time was 11.3 h, the mean intensive care (ICU) stay was 30.3 h, the mean hospital stay 8 days. There were no in-hospital deaths, postoperative myocardial infarctions or renal failures. Systematic control angiograms performed in the first 64 patients showed a 96.3% patency rate of the investigated anastomoses. CONCLUSION: Robotically assisted takedown of the IMA and direct off-pump anastomosis through a small anterolateral thoracotomy with no rib retraction appears to be safe, with minimal morbidity, little blood loss, and a reasonable ventilation time, ICU and hospital stay. It is recommended as the preferred method of revascularization for a growing number of indications and certainly an acceptable alternative to percutaneous transluminal coronary angioplasty.
Authors:
N Nesher; I Bakir; F Casselman; I Degrieck; R De Geest; F Wellens; W Willaert; Y Vermeulen; H Vanermen; F Van Praet
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  48     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-16     Completed Date:  2007-08-30     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  333-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Thoracic Surgery, OLV Clinic, Aalst, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Coronary Artery Disease / physiopathology,  surgery*
Endoscopy*
Feasibility Studies
Female
Follow-Up Studies
Humans
Internal Mammary-Coronary Artery Anastomosis / adverse effects,  methods*
Length of Stay
Male
Middle Aged
Retrospective Studies
Robotics*
Thoracotomy*
Time Factors
Treatment Outcome
Vascular Patency

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


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