Standard coronary artery bypass grafting and beating heart bypass. Indications and long-term results.
OBJECTIVE
We have performed 225 cases of coronary artery bypass grafting (CABG), between October 15 1995 and September 8 1999. We have evaluated the operative results of 121 cases (53.8%) of conventional CABG and 104 cases (46.2%) of minimally invasive coronary artery bypass grafting performed during this period. The average numbers of bypassed grafts was 3.45 for conventional CABG, and 1.41 for minimally invasive coronary artery bypass grafting. Sixty-seven right internal thoracic arteries, 145 left internal thoracic arteries, 71 gastroepiploic arteries, 38 radial arteries and 12 saphenous veins were used for conventional CABG, and 29 right internal thoracic arteries, 81 left internal thoracic arteries, 18 gastroepiploic arteries, 3 radial arteries, 10 saphenous veins and 2 inferior epigastric arteries were used for minimally invasive coronary artery bypass grafting. The total number of 303 grafts were anastomosed to 417 coronary arteries for conventional CABG, and 143 grafts were anastomosed to 147 coronary arteries for minimally invasive coronary artery bypass grafting.


RESULTS
Although two saphenous veins were occluded, the early postoperative patency rate was 100% for conventional CABG using right internal thoracic arteries, left internal thoracic arteries, gastroepiploic arteries and radial arteries. Three site of stenosis in 18 left internal thoracic arteries and 2 in 16 right internal thoracic arteries were recognized in minimally invasive coronary artery bypass grafting without the use of stabilizers. One site of stenosis in 63 left internal thoracic arteries was recognized in minimally invasive coronary artery bypass grafting with the use of stabilizers.


CONCLUSIONS
The use of stabilizers enables adaptation of the minimally invasive coronary artery bypass grafting procedure to a wider range of coronary artery bypass procedures, and a higher graft patency can be expected.
Takahashi
K
K
Department of Cardiovascular Surgery, Aomori Rhousai Hospital, 1 Shiroganemachi Minamigaoka, Hachinohe, Aomori 031-8551, Japan.
Oikawa
S
S
Minagawa
M
M
Hatakeyama
M
M
D001026:Coronary Artery Bypass / Q000592:standards* / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000601:surgery; D019074:Epigastric Arteries / Q000637:transplantation; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000592:standards* / Q000706:statistics & numerical data; D012501:Saphenous Vein / Q000637:transplantation; D014654:Vascular Patency