title: Multiple coronary artery bypass via mini left thoracotomy with conventional aortic occlusion.
abstract: 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.
authors.affiliation: San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015-2229, USA.
authors.forename: A
authors.initials: A
authors.lastname: Zapolanski
authors.forename: K
authors.initials: K
authors.lastname: Korver
authors.forename: M B
authors.initials: MB
authors.lastname: Pliam
authors.forename: L
authors.initials: L
authors.lastname: Mengarelli
authors.forename: R
authors.initials: R
authors.lastname: Shaw
mesh_terms: 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