Acuff T E, Landreneau R J, Griffith B P, Mack M J
Division of Cardiothoracic Surgery, Medical City Dallas Hospital, Texas, USA.
Ann Thorac Surg. 1996 Jan;61(1):135-7. doi: 10.1016/0003-4975(95)00907-8.
Standard options for the invasive management of proximal disease of the left anterior descending coronary artery include coronary artery bypass grafting with a left internal mammary artery and percutaneous transluminal coronary angioplasty.
We describe a surgical technique for bypass of the left anterior descending coronary artery with a left internal mammary artery without median sternotomy and without cardiopulmonary bypass. Thoracoscopy is used to harvest the internal mammary artery, whereas the mammary-coronary artery anastomosis is performed under direct vision through a limited anterior thoracotomy.
We have performed this procedure successfully in 3 patients with minimal morbidity and shortened hospital stay. Average operative time was 3 hours and postoperative hospital stay averaged less than 48 hours.
Although experience is limited and follow-up is very short, with further experience, this less invasive surgical technique may become a viable option for the management of proximal left anterior descending disease.
左前降支冠状动脉近端病变的侵入性治疗的标准选择包括使用左乳内动脉进行冠状动脉旁路移植术和经皮腔内冠状动脉成形术。
我们描述了一种不进行正中胸骨切开术和体外循环，使用左乳内动脉绕过左前降支冠状动脉的手术技术。胸腔镜用于获取乳内动脉，而乳内动脉与冠状动脉的吻合术则通过有限的前外侧开胸术在直视下进行。
我们已成功地对3例患者实施了该手术，发病率极低且住院时间缩短。平均手术时间为3小时，术后平均住院时间不到48小时。
尽管经验有限且随访时间很短，但随着经验的积累，这种侵入性较小的手术技术可能成为治疗左前降支近端病变的可行选择。
