Minimally invasive axillary-coronary artery bypass.

BACKGROUND

Some patients with proximal obstructive lesions of the left anterior descending coronary artery who are suitable for minimally invasive coronary bypass surgery do not have an available left internal mammary artery because it has already been used for a graft, is diseased or has been damaged. The ascending aorta is not accessible for proximal graft anastomosis from a small anterolateral thoracotomy used to expose the coronary artery. The aim of this report is to show that the axillary artery is suitable for the proximal anastomosis in minimally invasive coronary bypass operations.

METHODS

Ten patients had minimally invasive axillary-coronary artery bypass to the anterior descending coronary artery. Cardiopulmonary bypass was not used. The saphenous vein was used in nine and the radial artery in one.

RESULTS

Satisfactory grafts were achieved in all patients without mortality or major complications.

CONCLUSION

Grafts from the axillary artery can be used successfully for minimally invasive bypass to the anterior descending coronary artery.