title: Single-lung ventilation with contralateral lung deflation: a simplified method for multivessel off-pump coronary artery bypass grafting.
abstract: 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.
authors.affiliation: Heart Institute, São Paulo University Medical School-Brasil, São Paulo, SP 05403-900, Brazil. dcidallan@incor.usp.br
authors.forename: Luís Alberto O
authors.initials: LA
authors.lastname: Dallan
authors.forename: Luiz Augusto F
authors.initials: LA
authors.lastname: Lisboa
authors.forename: Fernando
authors.initials: F
authors.lastname: Platania
authors.forename: Sérgio A
authors.initials: SA
authors.lastname: Oliveira
authors.forename: Noedir A
authors.initials: NA
authors.lastname: Stolf
mesh_terms: 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