Minimally-invasive video-assisted coronary-artery bypass grafting.
BACKGROUND
In general, surgeries currently tend to be less invasive and cardiac surgery has started to follow this trend.


OBJECTIVE
To evaluate the evolution of one hundred patients undergoing minimally-invasive coronary artery bypass grafting.


METHODS
Access to the heart was attained through a small; 6-cm thoracotomy, located in the 4th left intercostal space, starting at the nipple. Through the same intercostal space, 3 cm after the primary incision, a 6.5-mm optical device was inserted at 30º. Where the saphenous vein was used, the pericardium was opened above the aorta and the latter was partially clamped with a systolic pressure of 80 mmHg, with the proximal anastomosis being carried out in the conventional manner. The distal anastomoses were carried out in the conventional manner. The procedure was performed off-pump using single lung ventilation.


RESULTS
The mean age was 63.9 ± 10.66 years. Sixty-eight (68%) patients were males. Fifty-three (53%) were in functional class III or IV. Left ventricular function was normal in fifty-three (53%) patients. Forty-two (42%) had undergone previous angioplasty. A total of 153 anastomoses were performed, ranging from 1 to 3. The average ventilation time was 4.06 ± 4.08 hours. Seventeen (17%) patients had atrial fibrillation and eight (8%) had pneumonia. There were two deaths in this series.


CONCLUSIONS
Revascularization was safe with low mortality and morbidity. With the advent of new devices, this surgery may have a greater applicability.
Pontifícia Universidade Católica do Paraná, PR- Brazil. grmilani@cardiol.br
Rodrigo Mussi
RM
Milani
Paulo
P
Brofman
Maximiliano
M
Guimarães
Márcia
M
Olandoski
Hugo
H
Meister Filho
Thales
T
Baggio
Maria Fernanda
MF
Domingues
Rodrigo
R
Jardim
Aline
A
Sanches
Francisco
F
Maia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D015203:Reproducibility of Results; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013908:Thoracotomy / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*