title: Angiographic evaluation of graft patency in minimally invasive direct coronary artery bypass grafting.
abstract: BACKGROUND
  The objective of this report is to describe our experience using minimally invasive direct coronary artery bypass grafting and to evaluate angiographic patency of anastomoses.
  
  
  METHODS
  A total of 120 patients (86 men) were operated on, with ages ranging from 30 to 83 years (mean = 61.2 years). Two access routes were used: for single left anterior descending coronary artery lesions an 8 cm anterior minithoracotomy was performed at the fourth left intercostal space. Extracorporeal circulation was not used. In the last 82 patients a restraining device was used for the regional reduction of heart beats. Coronary cineangiography was carried out between postoperative days 1 and 3 in 84 (70%) patients. Anastomoses were graded: grade A, no blocks; grade B, blocks of more than 50%; grade C, occlusion. This evaluation was performed for two different periods: in the first period a restraining device was not used and in the second period a restraining device was used.
  
  
  RESULTS
  In the first study period (38 anastomoses) coronary cineangiography showed grade A, 79%, grade B, 5.2%, and grade C, 15.8%. In the second study period (62 anastomoses), angiography showed grade A, 90.4%, grade B, 6.4%, and grade C, 3.2%. Early mortality was 1.6%.
  
  
  CONCLUSIONS
  Minimally invasive coronary artery bypass grafting is a good alternative for some groups of patients. Anastomotic results seem to be better when a restraining device is used.
authors.affiliation: Heart Institute (In Cor), University of São Paulo Medical School, Brazil. fabiojatene@incor.usp.br
authors.forename: F B
authors.initials: FB
authors.lastname: Jatene
authors.forename: P M
authors.initials: PM
authors.lastname: Pêgo-Fernandes
authors.forename: A C
authors.initials: AC
authors.lastname: Hueb
authors.forename: P
authors.initials: P
authors.lastname: Marques de Oliveira
authors.forename: L A
authors.initials: LA
authors.lastname: Dallan
authors.forename: R
authors.initials: R
authors.lastname: Fontes
authors.forename: R
authors.initials: R
authors.lastname: Coelho
authors.forename: N A
authors.initials: NA
authors.lastname: Stolf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002932:Cineangiography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013908:Thoracotomy / Q000379:methods; D014654:Vascular Patency