Minimally Invasive Total Arterial Coronary Artery Bypass Grafting in Left Main Stem Disease  

作　　者：Pradeep Nambiar Radwan Husseini Prashant Sagar Pradeep Nambiar;Radwan Husseini;Prashant Sagar(Dr. Sulaiman Al Habib Hospital, Dubai, UAE;Aster Hospital, Dubai, UAE)

机构地区：[1]Dr. Sulaiman Al Habib Hospital, Dubai, UAE [2]Aster Hospital, Dubai, UAE

出　　处：《World Journal of Cardiovascular Surgery》2024年第7期107-114,共8页心血管外科国际期刊（英文）

摘　　要：Objective: The aim was to show that Minimally Invasive total arterial revascularization for left main stem coronary artery disease, via a left anterior Mini thoracotomy using bilateral internal thoracic arteries is feasible, reproducible and safe. Further, there has been no exclusive data or experience with minimally invasive coronary artery bypass grafting in left main stem disease. Methods: From April 2019 to March 2024, 41 patients with left main stem stenosis, left main equivalent disease and unprotected left main with triple vessel disease underwent off pump minimally invasive multivessel coronary artery bypass grafting using either in situ pedicled Bilateral Internal Thoracic arteries or Left and Right Internal Thoracic artery Y composite conduits at three centers. Bilateral Internal Thoracic arteries were harvested under direct vision. All patients had an Intra-Aortic Balloon Pump inserted via the femoral artery prior to induction of anesthesia, to prevent any hemodynamic instability, arrhythmias, and was removed following completion of the procedure in the operating room without any complications. Efficacy and outcomes were evaluated by i) Primary (MACCE)-Major Adverse Cardiac and Cardiovascular events and ii) Secondary outcome measures including total length of stay, return to full physical activity and quality of life. Mean follow-up was 1.4 years (Maximum was 2.5 years). Results: 41 patients with left main stem coronary artery stenosis, underwent total arterial revascularization using bilateral internal thoracic arteries. Left main stem stenosis was present in 29 patients, Unprotected left main stem stenosis with triple vessel disease in 7 and left main equivalence in 5 patients. In this cohort, 29 patients with only left main stem stenosis had 2 grafts each, 7 patients with left main and triple vessel disease had 3 grafts and 5 patients with left main equivalent disease had 2 grafts respectively. The average number of grafts was 2.2. One patient was converted to open sternotomy as an emergency becauseObjective: The aim was to show that Minimally Invasive total arterial revascularization for left main stem coronary artery disease, via a left anterior Mini thoracotomy using bilateral internal thoracic arteries is feasible, reproducible and safe. Further, there has been no exclusive data or experience with minimally invasive coronary artery bypass grafting in left main stem disease. Methods: From April 2019 to March 2024, 41 patients with left main stem stenosis, left main equivalent disease and unprotected left main with triple vessel disease underwent off pump minimally invasive multivessel coronary artery bypass grafting using either in situ pedicled Bilateral Internal Thoracic arteries or Left and Right Internal Thoracic artery Y composite conduits at three centers. Bilateral Internal Thoracic arteries were harvested under direct vision. All patients had an Intra-Aortic Balloon Pump inserted via the femoral artery prior to induction of anesthesia, to prevent any hemodynamic instability, arrhythmias, and was removed following completion of the procedure in the operating room without any complications. Efficacy and outcomes were evaluated by i) Primary (MACCE)-Major Adverse Cardiac and Cardiovascular events and ii) Secondary outcome measures including total length of stay, return to full physical activity and quality of life. Mean follow-up was 1.4 years (Maximum was 2.5 years). Results: 41 patients with left main stem coronary artery stenosis, underwent total arterial revascularization using bilateral internal thoracic arteries. Left main stem stenosis was present in 29 patients, Unprotected left main stem stenosis with triple vessel disease in 7 and left main equivalence in 5 patients. In this cohort, 29 patients with only left main stem stenosis had 2 grafts each, 7 patients with left main and triple vessel disease had 3 grafts and 5 patients with left main equivalent disease had 2 grafts respectively. The average number of grafts was 2.2. One patient was converted to open sternotomy as an emergency because

关 键 词：Left Main Stem Minimally Invasive CABG Bilateral Internal Mammary Arteries 

分 类 号：R65[医药卫生—外科学]