Multiple coronary artery bypass via mini left thoracotomy with conventional aortic occlusion.
BACKGROUND
Complete myocardial revascularization can be achieved through a mini left anterior thoracotomy. Our approach (West Coast Technique) takes advantage of the Port-Access (Heartport, Redwood City, CA) concept while utilizing conventional instrumentation.


METHODS
Thirty-eight patients underwent multiple coronary artery bypass grafting (CABG). Aortic occlusion was performed using a transthoracic clamp, and all anastomoses were performed under a single cross-clamp.


RESULTS
There were no deaths and no neurologic deficits. There was one perioperative myocardial infarction (MI), and one re-exploration for bleeding. Ten patients (26%) required blood transfusions, and five patients (13%) developed atrial fibrillation. The average number of grafts per patient was 2.9, and average hospital stay was 5.2 days.


CONCLUSIONS
Multiple CABG can be accomplished safely through a minithoracotomy, which eliminates the need for endoaortic occlusion.
Zapolanski
A
A
San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015-2229, USA.
Korver
K
K
Pliam
M B
MB
Mengarelli
L
L
Shaw
R
R
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D013908:Thoracotomy