title: Lesions of the target vessel during minimally invasive myocardial revascularization.
abstract: BACKGROUND
  Minimally invasive coronary artery bypass grafting has recently been introduced into cardiac surgery. In this report we discuss the incidence of surgically induced distal target vessel stenosis in patients who undergo the minimally invasive coronary artery bypass grafting procedure, which represents a major drawback of the procedure in our experience.
  
  
  METHODS
  Doppler evaluation of mammary artery flow was performed postoperatively in all 55 patients who underwent minimally invasive coronary artery bypass grafting at our institution. Angiography was performed in the first 35 consecutive patients for control purposes and in 2 patients who complained of angina recurrence.
  
  
  RESULTS
  In 32 of the first 35 consecutive patients, the anastomosis was found to be functioning normally and the distal left anterior descending artery was normal; in the remaining 3 patients we found mammary artery occlusion, anastomotic stenosis, and stenosis of the anastomosis and the distal left anterior descending artery in 1 patient each. A distal left anterior descending artery stenosis was found in the only 2 patients who underwent late angiography.
  
  
  CONCLUSIONS
  Surgically induced distal target vessel stenosis represents a major drawback of minimally invasive coronary artery bypass grafting in our experience. Further improvement in the means of achieving coronary artery occlusion, as well as in anticoagulant and antiplatelet therapy, is mandatory before minimally invasive coronary artery bypass grafting can be confidently accepted into clinical practice.
authors.affiliation: Department of Cardiac Surgery, Catholic University, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Alessandrini
authors.forename: M
authors.initials: M
authors.lastname: Gaudino
authors.forename: F
authors.initials: F
authors.lastname: Glieca
authors.forename: N
authors.initials: N
authors.lastname: Luciani
authors.forename: F L
authors.initials: FL
authors.lastname: Piancone
authors.forename: M
authors.initials: M
authors.lastname: Zimarino
authors.forename: G
authors.initials: G
authors.lastname: Possati
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D003331:Coronary Vessels / Q000473:pathology*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications