Left internal mammary artery grafting to left anterior descending coronary artery by minimally invasive direct coronary artery bypass approach

被引:6
作者
Diegeler A. [1 ]
机构
[1] Klinik für Herzchrurgie, Universität Leipzig, Herzzentrum, 04289 Leipzig
关键词
Left Anterior Descend; Left Internal Mammary Artery; Left Internal Mammary Artery Grafting; Invasive Direct Coronary Artery Bypass; Total Endoscopic Coronary Artery Bypass;
D O I
10.1007/s11886-999-0058-0
中图分类号
学科分类号
摘要
New surgical techniques for the treatment of the isolated lesion of the left anterior descending coronary artery (LAD) include off-pump surgery, minimal access to the heart, and endoscopic or computer enhanced coronary artery bypass surgery. The term minimally invasive direct coronary artery bypass surgery (MIDCAB) is related to a leftside minithoracotomy, the harvest of the left internal mammary artery (IMA) under direct vision, and an anastomosis performed between IMA and LAD under direct vision, using the technique of mechanical local immobilization by a special device. Alternative techniques include endoscopic harvesting of the IMA, or as a new and still experimental approach, the closed-chest total endoscopic coronary artery bypass grafting (TECAB) with the use of a high tech telemanipulator system. The currently reported results demonstrate the safety of MIDCAB surgery (30-day mortality < 0.5%, perioperative myocardial infarction < 2%, early patency rate between 95% and 98%). Mid-term results after 6 months have shown a patency rate between 94% and 97%, and more than 90% of the patients are without any angina symptoms. Due to this promising results MIDCAB is an alternative treatment for high-grade LAD lesions. Copyright © 1999 by Current Science Inc.
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收藏
页码:323 / 330
页数:7
相关论文
共 55 条
[41]  
Diegeler A., Matin M., Kayser S., Et al., Angiographic results after minimally invasive coronary bypass grafting using the minimally invasive direct coronary grafting (MIDCAB) approach, Eur J Cardiothorac Surg, 15, 5, pp. 680-684, (1999)
[42]  
Gill I.S., FitzGibbon G.M., Higginson L.A.J., Et al., Minimally invasive coronary artery bypass: A series with early qualitative angiographic follow-up, Ann Thorac Surg, 64, pp. 710-712, (1997)
[43]  
Mack M.J., Osborne, Shennib H., Arterial graft patency in coronary artery bypass grafting: What do we really know?, Ann Thorac Surg, 66, pp. 1055-1059, (1998)
[44]  
Barner H.B., Mudd J.G., Mark A.L., Et al., Patency of internal mammary-coronary grafts, Circulation, 54, SUPPL. 3, pp. 70-73, (1976)
[45]  
Berger P.B., Alderman E.L., Schaff H.V., Frequency of early occlusion and stenosis in the left internal mammary artery among patients undergoing CABG through median sternotomy on conventional bypass: Benchmark for the MIDCAB, Circulation, 96, SUPPL. 1, (1997)
[46]  
Boylan M.J., Lytle B.W., Loop F.D., Et al., Surgical treatment of isolated left internal mammary artery and venous autograft at 18 to 20 years follow-up, J Thorac Cardiovasc Surg, 107, pp. 657-662, (1994)
[47]  
FitzGibbon G.M., Kafka H.P., Leach A.J., Et al., Coronary bypass graft fate and patients outcome: Angiographic follow-up of 5,065 grafts related to survival and reoperation in 1,38 patients during 25 years, J Am Coll Cardiol, 28, pp. 616-626, (1996)
[48]  
Ivert T., Huttunen K., Landou C., Bjork V.O., Angiographic studies of internal mammary artery grafts 11 years after coronary artery bypass grafting, J Thorac Cardiovasc Surg, 96, pp. 1-12, (1988)
[49]  
Allen K.B., Matheny R.G., Robison R.J., Et al., Minimally invasive versus conventional reoperative coronary artery bypass, Ann Thorac Surg, 64, pp. 616-622, (1997)
[50]  
Doty J.R., Salazar J.D., Fonger J.D., Et al., Reoperative MIDCAB grafting: 3-years clinical ecperience, Eur J Cardiothorac Surg, 13, 6, pp. 641-649, (1998)