Video-assisted coronary artery bypass grafting during hypothermic fibrillatory arrest.
BACKGROUND
Hypothermic fibrillatory arrest without aortic cross-clamping is a technique for quieting the heart during coronary artery bypass grafting. This report reviews the preliminary results with this technique in 4 patients having video-assisted coronary artery bypass grafting.


METHODS
Four male patients 28.5 to 64.5 years old (mean age, 45.4 years) underwent operation for unstable angina. With video-assisted techniques, coronary artery bypass grafting was performed through a left anterior minithoracotomy with femoral-femoral cardiopulmonary bypass without cross-clamping the aorta. The myocardium was protected by continuous coronary perfusion during hypothermic fibrillatory arrest.


RESULTS
A left internal thoracic artery graft was anastomosed to the left anterior descending coronary artery in each patient. The posterior descending branch of the right coronary artery was grafted with a pedicled right gastroepiploic artery in 1 patient. The duration of cardiopulmonary bypass was 72 to 127 minutes (mean duration, 92 +/- 21 minutes). The postoperative course of each patient was uneventful. Follow-up (range, 3.9 to 5.8 months; mean follow-up, 4.9 months) was complete for all patients. There were no late deaths. Coronary angiography showed patent grafts. All patients were in New York Heart Association functional class I or II (mean class, 1.25).


CONCLUSIONS
Hypothermic fibrillatory arrest is a simple and effective method of quieting the heart, thereby providing a motionless operative field for video-assisted coronary artery bypass grafting.
Lin
P J
PJ
Divisions of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Chang
C H
CH
Chu
J J
JJ
Liu
H P
HP
Tsai
F C
FC
Lin
F C
FC
Chiang
C W
CW
Yang
M W
MW
Tan
P P
PP
D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods; D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D003331:Coronary Vessels / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013895:Thoracic Arteries / Q000601:surgery; D013908:Thoracotomy / Q000379:methods*