Minimally invasive coronary artery bypass grafting.
BACKGROUND
Standard options for the invasive management of proximal disease of the left anterior descending coronary artery include coronary artery bypass grafting with a left internal mammary artery and percutaneous transluminal coronary angioplasty.


METHODS
We describe a surgical technique for bypass of the left anterior descending coronary artery with a left internal mammary artery without median sternotomy and without cardiopulmonary bypass. Thoracoscopy is used to harvest the internal mammary artery, whereas the mammary-coronary artery anastomosis is performed under direct vision through a limited anterior thoracotomy.


RESULTS
We have performed this procedure successfully in 3 patients with minimal morbidity and shortened hospital stay. Average operative time was 3 hours and postoperative hospital stay averaged less than 48 hours.


CONCLUSIONS
Although experience is limited and follow-up is very short, with further experience, this less invasive surgical technique may become a viable option for the management of proximal left anterior descending disease.
Acuff
T E
TE
Division of Cardiothoracic Surgery, Medical City Dallas Hospital, Texas, USA.
Landreneau
R J
RJ
Griffith
B P
BP
Mack
M J
MJ
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D004724:Endoscopy; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D013906:Thoracoscopy; D014654:Vascular Patency