Single-lung ventilation with contralateral lung deflation: a simplified method for multivessel off-pump coronary artery bypass grafting.
There are many new alternative methods of minimally invasive myocardial revascularization that can be applied in selected patients who have multivessel coronary artery disease. However, these techniques often require new and expensive equipment. Most multivessel myocardial revascularization is performed via median sternotomy and involves the use of a conventional endotracheal tube. Both lungs are ventilated, and frequently the left pleural cavity is opened. In contrast, single-lung deflation naturally moves the mediastinum within the thorax toward the collapsed lung, without the need to open the pleural cavities. Herein, we describe a simple alternative procedure that facilitates off-pump multivessel coronary artery bypass grafting via complete median sternotomy: single-lung ventilation with contralateral lung deflation. This technique better exposes the more distal right and circumflex coronary artery branches with or without the opening of the pleural cavities.
Dallan
Luís Alberto O
LA
Heart Institute, São Paulo University Medical School-Brasil, São Paulo, SP 05403-900, Brazil. dcidallan@incor.usp.br
Lisboa
Luiz Augusto F
LA
Platania
Fernando
F
Oliveira
Sérgio A
SA
Stolf
Noedir A
NA
D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation* / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D008323:Mammary Arteries / Q000637:transplantation; D008482:Mediastinum; D019060:Minimally Invasive Surgical Procedures; D035422:Pleural Cavity / Q000601:surgery; D017534:Radial Artery / Q000637:transplantation; D015203:Reproducibility of Results; D012121:Respiration, Artificial / Q000295:instrumentation*; D012501:Saphenous Vein / Q000637:transplantation; D013249:Sternum / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods; D015919:Ventilators, Negative-Pressure