title: [A case of MIDCAB to the left circumflex via the left posterolateral thoracotomy].
abstract: There have been many reports of MIDCAB to left anterior descending artery via a small dissection utilizing the left anterolateral thoracotomy. We report here a case of CABG reoperation to the circumflex artery by MIDCAB via the left posterolateral thoracotomy. A 66-year-old male patient had received a 3 branch bypass graft on the LITA-LAD and the SVG-OM-4 PD at another institution. Postoperative angiography revealed a SVG occlusion. Since repeated intervention was unsuccessful, reoperation was necessary. To preserve the patency of the LITA, the 4th left intercostal posterolateral thoracotomy was selected. We utilized a commercially available rib retractor for MIDCAB, as well as a stabilizer and a CO2 blower to obtain a nearly perfect bloodless stabilized view. A new SVG was used to connect the left circumflex artery. The operation was successful without any postoperative complications or need for transfusion. After a two week hospital stay, the graft patency was confirmed and the patient was discharged.
authors.affiliation: Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Tochigi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Okamura
authors.forename: Y
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: H
authors.initials: H
authors.lastname: Iida
authors.forename: H
authors.initials: H
authors.lastname: Mori
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Shimada
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012008:Recurrence; D015607:Stents; D019616:Thoracic Surgical Procedures; D013908:Thoracotomy / Q000379:methods*