Grujic Danko, Aleksic Vojkan, Gazibara Tatjana, Milicevic Vladimir, Karan Radmila
Department of Cardiac Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Braz J Cardiovasc Surg. 2025 May 30;40(5):e20240193. doi: 10.21470/1678-9741-2024-0193.
Minimally invasive direct coronary artery bypass grafting (MIDCAB) has considerable benefits over the conventional coronary artery bypass grafting procedure. This case report presents the MIDCAB procedure in a multivessel coronary disease using triple arterial grafts and four arterial anastomoses. The initial anastomosis was made between the left intrathoracic mammary artery (LIMA) and the radial artery (RA), as an end-to-side "T" graft. Next, the RIMA was used to left anterior descending anastomosis. The first obtuse marginal (OM1) branch was grafted to allow LIMA-OM1 side-to-side anastomosis. Then, with the diagonal branch (Dg) opened, the formation of a "jumping" anastomosis was made using LIMA-OM1-Dg. The posterior descending artery (PDA) was used to create a LIMA-RA-PDA.
微创直接冠状动脉旁路移植术（MIDCAB）相对于传统冠状动脉旁路移植术有诸多显著优势。本病例报告介绍了在多支冠状动脉疾病中使用三根动脉移植物和四个动脉吻合口进行的MIDCAB手术。最初的吻合是在左胸廓内动脉（LIMA）和桡动脉（RA）之间进行，作为端侧“T”形移植物。接下来，右胸廓内动脉用于左前降支吻合。第一钝缘支（OM1）进行移植，以实现LIMA-OM1侧侧吻合。然后，在对角支（Dg）打开的情况下，使用LIMA-OM1-Dg形成“跳跃”吻合。后降支动脉（PDA）用于构建LIMA-RA-PDA。
