Minimally Invasive Coronary Artery Bypass Grafting on the Beating Heart
The prospect of grafting the internal mammary artery (IMA) to the left anterior descending (LAD) artery via a thoracotomy without the aid of cardiopulmonary bypass (CPB) was first explored by Kolessov in 1967 (1), and further applied by Favaloro (2),Garrett (3),Trapp (4),and others. The early wave of enthusiasm for this technique soon wavered with the widespread availability of CPB and cardioplegia, which allowed for a motionless and bloodless operative field. The unequivocal and widespread success of conventional coronary artery bypass grafting (CABG) limited the use of unsupported bypass grafting. Two developments in the early 1990s revived the technique of myocardial revascularization without CPB: (1) the emergence of minimally invasive technology applicable to the chest, and (2) the promising results of “pumpless” bypass grafting reported by a number of authors (5–7).
KeywordsLeft Anterior Descend Internal Mammary Artery Beating Heart Inferior Epigastric Artery Left Anterior Descend Occlusion
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