Minimally invasive surgical technique for the treatment of multivessel coronary artery disease.
BACKGROUND
To avoid sternotomy-related complications after cardiac operations, we developed a minimally invasive surgical technique for the treatment of multivessel coronary artery disease.


METHODS
From November 1996 to May 1997, 39 patients (age range, 50 to 78 years) with coronary artery disease were treated with the use of this technique. Through a small (6- to 9-cm) left lateral chest incision in the third intercostal space, the left internal mammary artery was harvested directly. With the use of cardiopulmonary bypass and cardioplegic arrest in all patients except 1, the left internal mammary artery was anastomosed to the left anterior descending artery. In addition, vein grafts and other arterial conduits were used for revascularization of the other coronary arteries.


RESULTS
There were no intraoperative complications. All the patients survived the procedure and had an uneventful postoperative course. Wound complications occurred in 2 patients. The median (+/- standard error of the mean) hospital stay was 6 +/- 1 days.


CONCLUSIONS
This technique combines minimally invasive surgical conditions with the safety standards of routine cardiac operations. With the use of this approach, even extensive coronary artery disease can be treated.
Gulielmos
V
V
Cardiovascular Institute, University Hospital Dresden, Germany.
Knaut
M
M
Wagner
F M
FM
Schüler
S
S
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006324:Heart Arrest, Induced; D006760:Hospitalization; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods; D007431:Intraoperative Complications; D007902:Length of Stay; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012449:Safety; D012501:Saphenous Vein / Q000637:transplantation; D013249:Sternum / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D013908:Thoracotomy / Q000379:methods