Stephenson E R, Ducko C T, Sankholkar S, Hoenicke E M, Prophet G A, Damiano R J
Department of Surgery, The Milton S. Hershey Medical Center, Penn State Geisinger Health System, Hershey 17033, USA.
Ann Thorac Surg. 1999 Sep;68(3):838-43. doi: 10.1016/s0003-4975(99)00794-8.
With traditional instruments, endoscopic coronary artery bypass grafting (ECABG) has not been possible. This study was designed to determine the feasibility of using a robotically-assisted microsurgical system to perform ECABG in a chronic animal model.
Nine calves were placed on cardiopulmonary bypass after harvesting the left internal mammary artery (LIMA). Subxiphoid endoscopic ports (2 instrument, 1 camera) were placed, and a robotic system was used to perform ECABG between the LIMA and left anterior descending coronary artery. LIMA graft flow (LIMAQ) was measured. Animals were sacrificed at 1 month, and hearts underwent angiographic and histologic analyses.
Acute graft patency was 89% (8/9). Two animals died suddenly within the first 48 hours. There was no significant difference in mean acute and chronic (n = 6) LIMAQ (40.9+/-4.7 and 38.5+/-5.0 ml/min, respectively). Survivors had an angiographic patency rate of 100% (6/6), confirmed by histology.
This study shows that ECABG is feasible in a chronic animal model with excellent results.
使用传统器械无法进行内镜冠状动脉旁路移植术（ECABG）。本研究旨在确定在慢性动物模型中使用机器人辅助显微手术系统进行ECABG的可行性。
在获取左乳内动脉（LIMA）后，对9头小牛进行体外循环。放置剑突下内镜端口（2个器械端口、1个摄像端口），并使用机器人系统在LIMA与左冠状动脉前降支之间进行ECABG。测量LIMA移植物血流量（LIMAQ）。1个月后对动物实施安乐死，并对心脏进行血管造影和组织学分析。
急性移植物通畅率为89%（8/9）。2只动物在最初48小时内突然死亡。急性和慢性（n = 6）平均LIMAQ无显著差异（分别为40.9±4.7和38.5±5.0 ml/分钟）。存活者的血管造影通畅率为100%（6/6），组织学检查证实。
本研究表明，ECABG在慢性动物模型中是可行的，效果良好。
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