Document Detail


A novel internal thoracic artery harvesting technique via subxiphoid approach--for the least invasive coronary artery bypass grafting.
MedLine Citation:
PMID:  19720658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have performed 12 cases of robotically assisted coronary artery bypass grafting (CABG) to accomplish less invasive revascularization. In this report, we describe a new method of robotically assisted internal thoracic artery (ITA) harvesting via subxiphoid approach, using the da Vinci surgical system. A 22-year-old man with three-vessel coronary artery disease due to Kawasaki disease was referred to our institution for coronary artery revascularization. A small subxiphoid incision was made, and the xiphoid process at the lower end of the sternum was excised. A U-shaped hook was inserted into the retrosternal space, and the lower sternum was lifted. A 30 degrees angle-up camera was inserted under the U-shaped hook, bilateral ITAs were harvested in a totally skeletonized fashion endoscopically. The required time for right ITA harvesting was 50 min, and that for the left was 20 min. After bilateral ITAs were harvested, composite grafts were made, and then the distal anastomoses were made. The patient was discharged six days after the operation. We performed a new robotically assisted bilateral ITA harvesting technique via sub-xiphoid safely and with excellent results. This method might be an evolutionary step of minimally invasive direct coronary artery bypass (MIDCAB) using the da Vinci surgical system.
Authors:
Munehisa Takata; Go Watanabe; Teruaki Ushijima; Norihiko Ishikawa
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-08-31
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-15     Completed Date:  2009-12-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  891-2     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, Tokyo Medical University, Tokyo, Japan. takatamunehisa0223@yahoo.co.jp
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass*
Coronary Artery Disease / etiology,  surgery*
Humans
Male
Mammary Arteries / transplantation*
Mucocutaneous Lymph Node Syndrome / complications,  surgery
Robotics*
Severity of Illness Index
Surgery, Computer-Assisted*
Surgical Procedures, Minimally Invasive
Tissue and Organ Harvesting / methods*
Treatment Outcome
Young Adult

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


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