Pande Shantanu, Agarwal Surendra K, Gupta Devendra, Mohanty Satayapriya, Kapoor Aditya, Tewari Satyendra, Bansal Anubhav, Ambesh Sushil P
Additional Professor, Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Indian Heart J. 2014 Mar-Apr;66(2):193-6. doi: 10.1016/j.ihj.2014.02.010. Epub 2014 Feb 28.
Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. This technique coupled with use of off pump technique of surgical revascularization makes it truly less invasive. This method is highly effective even in high-risk patients. Results of this procedure are comparable to standard off pump technique and are better than percutaneous coronary intervention utilizing drug-eluting stent. We present an early and mid-term result of the use of this technique.
We enrolled 33 patients for analysis operated between 2008 and 2012. Operation was performed utilizing off-pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Median follow up of 2.5 years (6 months-4 years) is available.
Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 7, double vessel in 14 and triple vessel disease in 12 patients. All the patients had normal left ventricular size and function. There was no operative and 30-day mortality. Conversion to median sternotomy to complete the operation was done in 6.6% (2 out of 33 patients). One patient had acute myocardial infarction and there were no deaths during follow up.
MICABG is a safe and effective method of revascularization in low risk candidates for coronary artery bypass grafting.
微创冠状动脉旁路移植术(MICABG)是一种侵入性较小的手术血运重建方法。该技术与非体外循环手术血运重建技术相结合,使其真正具有较小的侵入性。即使在高危患者中,这种方法也非常有效。该手术的结果与标准非体外循环技术相当,且优于使用药物洗脱支架的经皮冠状动脉介入治疗。我们展示了使用该技术的早期和中期结果。
我们纳入了2008年至2012年间接受手术的33例患者进行分析。手术通过微创切口采用非体外循环冠状动脉旁路移植技术进行。单支血管病变采用左乳内动脉移植,如有需要,其他移植血管采用桡动脉。可获得的中位随访时间为2.5年(6个月至4年)。
中位年龄为58.5岁(41 - 77岁),均为男性。7例为单支血管病变,14例为双支血管病变,12例为三支血管病变。所有患者左心室大小和功能均正常。无手术死亡和30天内死亡。6.6%(33例患者中的2例)转为正中开胸完成手术。1例患者发生急性心肌梗死,随访期间无死亡。
对于冠状动脉旁路移植术的低风险候选者,MICABG是一种安全有效的血运重建方法。