title: Off-pump minimally invasive coronary artery bypass grafting using the bilateral internal thoracic arteries and the right gastroepiproic artery.
abstract: We report our initial experience of an off-pump total arterial minimally invasive coronary arterial bypass grafting (MICS CABG) with the use of bilateral internal thoracic arteries (BITA) and the right gastroepiproic artery. A 47-year old male with renal dysfunction secondary to diabetes mellitus was admitted for heart failure due to severe triple-vessel disease. Off-pump MICS CABG with total arterial grafts was elected because the patient refused to undergo median sternotomy due to the strong desire to regain the baseline function promptly. Total arterial grafts were selected to maximize the potential long-term outcome. There were no postoperative complications except temporary dialysis. Postoperative coronary computed tomography revealed the patency of all grafts. Our experience suggests that BITA can be safely harvested under direct vision in MICS CABG. Total arterial graft revascularization with BITA via minimally invasive approach may offer the benefits of MICS CABG while providing the undetermined but potentially superior conduit longevity of arterial grafts.
authors.affiliation: Division of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Kanagawa, Japan k-kikuchi@seiwa.or.jp.
authors.forename: Keita
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Division of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Kanagawa, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Une
authors.affiliation: Division of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Kanagawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kurata
authors.affiliation: Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Ruel
mesh_terms: D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*
keywords: Bilateral internal thoracic artery; Minimally invasive coronary artery bypass grafting; Total arterial graft