INNOVATIVE APPROACH – MINIMALLY INVASIVE MULTIVESSEL CORONARY GRAFTING THROUGH A LEFT ANTERIOR THORACOTOMY

Abstract

Personal experience with minimally invasive multivessel coronary grafting through left anterior thoracotomy is described. Currently, we use this technique routinely, regardless of the number of grafts, quality, and location of coronary targets, left ventricular ejection fraction, age, gender, body mass index. \nOur aim was to develop minimally invasive coronary artery bypass grafting technique, which would be equally effective and safe as compared to the conventional coronary grafting technique; would be reproducible and be applied for every patient with isolated coronary artery disease. 220 patients were operated and then analyzed. In all patients, complete revascularization was performed. Mean number of grafts was 3.37± 0.68 per patient (range 2-5). Left internal mammary artery was used in 206 patients, right internal mammary artery - in 4 patients, radial artery - in 37 patients, vein grafts - in 193 patients. Complete arterial revascularization was performed in 29 patients. We had no mortality. Mean aortic cross-clamp time was 70.7 ± 18.7 min (range 31 - 146 min). Mean cardiopulmonary bypass time was 137.5 ± 31.9 min (range 71 - 339 min). Postoperatively, total drainage in the first 12 hours was 376.7 ± 205.4 ml, ventilation time was 2.6 ± 1.4 hours, ICU stay was 2.3 ± 1.2 days. \nConclusion. Minimally invasive coronary bypass grafting is an effective and safe surgical method. Complete revascularization could be performed regardless of the number of grafts, left ventricle ejection fraction, quality and size of coronary vessels, or age of the patient.