Initiation and modification of minimally invasive coronary artery bypass grafting
- 46 Downloads
Minimally invasive coronary artery bypass grafting (MICS CABG) via a small left thoracotomy has been proposed as an alternative to standard coronary artery bypass grafting. However, this technique is still limited to skillful surgeons. Off-pump multi-vessel bypass grafting and the use of bilateral internal thoracic arteries are particularly challenging via a small thoracotomy, while they are widely performed via a full median sternotomy. The purpose of this review is to serve as a guide for the proper introduction of MICS CABG in the current era. We examine the advances, current techniques, outcomes and learning curves of MICS CABG and discuss the safe introduction.
KeywordsCoronary artery bypass grafting Left thoracotomy Minimally invasive coronary artery bypass grafting
Compliance with ethical standards
Conflict of interest
The authors have declared that no conflict of interest exists.
- 1.Mohr FW, Morice M-C, Kappetein AP, Feldman TE, Ståhle E, Colombo A, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013;381(9867):629–38.CrossRefGoogle Scholar
- 4.Kowalewski M, Pawliszak W, Malvindi PG, Bokszanski MP, Perlinski D, Raffa GM, et al. Off-pump coronary artery bypass grafting improves short-term outcomes in high-risk patients compared with on-pump coronary artery bypass grafting: meta-analysis. J Thorac Cardiovasc Surg. 2016;151(1):60–77 e1–58.CrossRefGoogle Scholar
- 5.(JACAS) TSCoJAfCAS. Coronary artery surgery results. http://www.jacas.org/data/pdf/slide_2016_e.pdf. Japanese Association for Coronary Artery Surgery. 2016.
- 11.Sezai Y. Coronary artery surgery results in 2012 http://www.jacas.org/enquete/2012.html: Japanese Association for Coronary Artery Surgery.
- 13.Rodriguez M, Ruel M. Minimally invasive coronary artery bypass grafting. Sellke F, Ruel M, editors. Phyladelphya: Elsevier; 2018. pp. 70–84.Google Scholar
- 14.Chan V, Lapierre H, Sohmer B, Mesana TG, Ruel M. Handsewn proximal anastomoses onto the ascending aorta through a small left thoracotomy during minimally invasive multivessel coronary artery bypass grafting: a stepwise approach to safety and reproducibility. Semin Thorac Cardiovasc Surg. 2012;24(1):79–83.CrossRefGoogle Scholar
- 19.Rogers CA, Pike K, Angelini GD, Reeves BC, Glauber M, Ferrarini M, et al. An open randomized controlled trial of median sternotomy versus anterolateral left thoracotomy on morbidity and health care resource use in patients having off-pump coronary artery bypass surgery: the Sternotomy Versus Thoracotomy (STET) trial. J Thorac Cardiovasc Surg. 2013;146(2):306–16 (e1–9) CrossRefGoogle Scholar
- 20.Alexander JH, Hafley G, Harrington RA, Peterson ED, Ferguson TB Jr, Lorenz TJ, et al. Efficacy and safety of edifoligide, an E2F transcription factor decoy, for prevention of vein graft failure following coronary artery bypass graft surgery: PREVENT IV: a randomized controlled trial. JAMA. 2005;294(19):2446–54.CrossRefGoogle Scholar