title: Robotically assisted multivessel minimally invasive direct coronary artery bypass grafting with the use of bilateral internal thoracic arteries.
abstract: This case report presents the robotically assisted multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB) technique using the bilateral internal thoracic arteries. A 54-year-old man with multivessel coronary artery disease was considered eligible for a robotically assisted myocardial revascularization. The bilateral internal thoracic arteries were harvested completely in a totally skeletonized fashion through three 1-2-cm-long incisions on the left thoracic wall. A small left anterior thoracotomy was then performed. The left internal thoracic artery was anastomosed to the left anterior descending coronary artery, and the composite radial artery graft from the right internal thoracic artery was sequentially anastomosed to the first diagonal branch, the obtuse marginal branch, and the distal right coronary artery on the beating heart without cardiopulmonary bypass. The harvesting time of the grafts was 66 min, and the total operative time was 5 h 58 min. Postoperative angiography revealed that all grafts were widely patent. The postoperative course was uneventful, and the patient was discharged 10 days after the operation. Robotically assisted MIDCAB using the bilateral thoracic arteries is a safe and effective means of myocardial revascularization for patients with multivesssel disease.
authors.affiliation: Division of Cardiac Surgery, Tokyo Medical University, Tokyo, Japan. snishida@k6.dion.ne.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Nishida
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Yasuda
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Shintani
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ito
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tabata
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawachi
mesh_terms: D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000379:methods; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics; D013997:Time Factors