Bilateral minimally invasive direct coronary artery bypass grafting with the use of two arterial grafts

Abstract

From the Department of Surgery (1), Toyama Medical and Pharmaceutical University, Toyama, Japan. Received for publication Dec. 31, 1996; accepted for publication Jan. 8, 1997. Address for reprints: Go Watanabe, MD, Department of Surgery (1), Toyama Medical and Pharmaceutical University, Sugitani, Toyama 2630, 930-01, Japan. J Thorac Cardiovasc Surg 1997;113:949-51 Copyright ~3 1997 by Mosby-Year Book, Inc. 0022-5223/97 $5.00 + 0 12/54/80237 with almost no mortality) However, this procedure is limited because 0nly the LAD and diagonal branches are accessible through the left minithoracotomy. Furthermore, this procedure cannot be used in patients with double or triple vessel disease. We have developed a new technique that allows us to perform minimally invasive direct CABG in the setting of multivessel disease, using small bilateral anterior thoracotomies. Small left and right anterior thoracotomies and direct coronary artery revascularization with arterial grafts were performed in one patient. A new surgical approach to CABG for the LAD and right coronary artery (RCA), without the use of extracorporeal circulation, is described. Case report. A 47-year-old man had a history of increasing postinfarction angina and severe congestive heart failure. Cardiac catheterization revealed total occlusions