title: [Minimally invasive direct coronary artery bypass grafting (MIDCAB) for right and circumflex coronary artery systems].
abstract: BACKGROUND
  Single-vessel coronary bypass grafting of the left internal thoracic artery (LITA) to the left anterior descending coronary artery (LAD) with mini-thoracotomy has been shown to produce excellent results with almost no mortality. However this procedure cannot be used in patients with double or triple vessel disease.
  
  
  METHODS
  Between Aug. 96 and Dec. 97, 17 pts underwent minimally invasive direct coronary artery bypass (MIDCAB) to right (RCA) and circumflex coronary artery (CX). LITA and RITA were thoracicscopically harvested and the right gastroepiploic artery (RGEA), inferior epigastric artery, and radial artery were then harvested. A limited left thoracotomy in combination with limited anterior right thoracotomy (n = 3) or right lower parasternal incision extending to below the xiphoid process (n = 6) were made. The double MIDCAB as performed in 16 pts and triple in 1 pt.
  
  
  RESULTS
  There was no operative death. At follow up, all pts are alive and well. The postoperative angiographic studies showed 30/31 grafts were patent.
  
  
  CONCLUSIONS
  The utility of multi-vessel MIDCAB for the LAD, CX and RCA with in-site arterial grafts has been demonstrated in the present study. This less invasive surgical technique may become a viable option for the management of multi-vessel coronary artery disease.
authors.affiliation: Department of Surgery, Toyama Medical and Pharmaceutical University, Japan.
authors.forename: G
authors.initials: G
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Misaki
authors.forename: K
authors.initials: K
authors.lastname: Kotoh
authors.forename: H
authors.initials: H
authors.lastname: Furuta
authors.forename: K
authors.initials: K
authors.lastname: Ueyama
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000473:pathology / Q000601:surgery; D019074:Epigastric Arteries / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures