[A successful case of minimally invasive direct coronary artery bypass (MIDCAB) followed by PTCA].
A 70-year-old man who developed angina pectoris underwent cardiac catheterization, which showed total occlusion of the left anterior descending coronary artery (LAD), associated with 75% stenosis of the right coronary artery (RCA) and 90% stenosis of the small circumflex coronary artery (CX). The LAD received good collateral flow from the RCA. The patient was scheduled to undergo the MIDCAB for the LAD using the internal thoracic artery (ITA), combined with percutaneous transluminal coronary angioplasty (PTCA) for the RCA subsequently. A left anterior submammarian skin incision of 10 cm in length was made. The fifth costal cartilage was removed. The left ITA was directly harvested from the chest wall from the 4th to 7th intercostal space, and was anastomosed to the midportion of the LAD without cardiopulmonary bypass. The patient was quickly recovered after the operation. On the 8th postoperative day, the patient successfully underwent the PTCA for the RCA after the ITA-LAD graft had been verified to be patent. The MIDCAB could be indicated for multivessel coronary disease in conjunction with the PTCA.
Nishina
T
T
Department of Cardiovascular Surgery, Kyoto University School of Medicine, Japan.
Matsuda
K
K
Nomoto
S
S
Nishimura
K
K
Koshiji
T
T
Sato
T
T
Ueyama
K
K
Nonaka
M
M
Ban
T
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000628:therapy; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures