title: Minimally invasive left anterior descending coronary artery revascularisation in high-risk patients with three-vessel disease.
abstract: We reviewed our experience over a 12 month period with using minimally invasive direct coronary artery bypass (MIDCAB) for the management of high-risk patients with three-vessel coronary artery disease. Twenty patients (4 females, mean age 67 years) received left internal mammary artery (LIMA) grafts to the left anterior descending (LAD) coronary artery. Associated co-morbidity included: severe chronic renal failure, severe extensive arteriopathy, chronic obstructive airway disease, poor general condition and severely impaired left ventricular function. There was one early postoperative mortality and no other cardiac-related morbidity. Graft patency investigated, using angiography was 90%, and 5 patients underwent follow-up angioplasty to other coronary arteries. All patients remain entirely angina free at a follow-up period between 3 and 12 months. We conclude that MIDCAB is a safe and effective approach for managing high-risk patients with three-vessel coronary artery disease.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
authors.forename: M B
authors.initials: MB
authors.lastname: Izzat
authors.forename: A P
authors.initials: AP
authors.lastname: Yim
authors.forename: M H
authors.initials: MH
authors.lastname: El-Zufari
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001018:Aortic Diseases / Q000150:complications; D016893:Carotid Stenosis / Q000150:complications; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D007902:Length of Stay; D008173:Lung Diseases, Obstructive / Q000150:complications; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies