Miniinvasive multivessel coronary grafting through left anterior thoracotomy

Abstract

The aim — to describe personal experience of miniinvasive multivessel coronary grafting through left anterior mini­thoracotomy with the application of artificial bloodcirculation and hyperkalemic blood cardioplegia; to assess the results of surgery in the first group patients.Materials and methods. The method was performed for 29 patients. All patients underwent complete myocardium revascularization with 2 — 5 grafts (3.37 ± 0.82 per patient). Left internal mammary artery was used in all patients, right internal mammary artery — in 4 patients, radial artery — in 5 patints, vein grafts — in 23 patients. Complete arterial revascularization was performed in 6 patients.Results and discussion. We had no fatal outcomes. Mean aortic crossclamp time was 75.8 ± 21 min (range 48 — 146 min). Mean cardiopulmonary bypass time was 145.5 ± 38.37 min (range 103 — 296 min). Total surgery duration was 180 — 495 min. (mean 287.4 ± 61.7). Postoperatively, total drainage in the first 12 hours was 456.55 ± 214.39 ml, the post surgery grafts were left for 48 hours. Ventilation time was 7.6 ± 15.6 hours, ICU stay was 2.58 ± 1.21 days.Conclusions. Miniinvasive coronary bypass grafitng is effective and safe surgical method for miocardium revascularization. Complete revascularization could be performed regardless the number of grafts, left ventricle ejection fraction, quality and size of coronary vessels, age of patient.