Shiono M, Sezai Y
The Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Artif Organs. 1998 Sep;22(9):769-74. doi: 10.1046/j.1525-1594.1998.06171.x.
Minimally invasive coronary artery bypass grafting (CABG) aims to avoid cardiopulmonary bypass and take maximum advantage of a smaller incision. Minimally invasive direct coronary artery bypass (MIDCAB) surgery is performed on selected arteries of the beating heart under direct vision through a choice of small incisions. Short-term results show good patency rates and a dramatic impact in terms of shorter hospital stays and cost effectiveness. The procedure is also being used increasingly in Japan. However, valid concerns have been raised about the quality of the anastomosis fashioned on a beating heart with pharmacologic bradycardia, and the long-term result of this technique is still questionable. The combined use of circulatory assist devices and mechanical stabilizing devices will be expected to expand access to coronary arteries by allowing for decompression of the left ventricle, permitting retraction and rotation of the heart, and hopefully further improvement of the results. Less invasive coronary surgery should be proven to be as effective and safe as conventional CABG before widespread adoption.
微创冠状动脉旁路移植术（CABG）旨在避免体外循环，并最大限度地利用较小的切口。微创直接冠状动脉旁路移植术（MIDCAB）是在直视下通过选择小切口对跳动心脏的选定动脉进行手术。短期结果显示通畅率良好，在缩短住院时间和成本效益方面有显著影响。该手术在日本也越来越多地被使用。然而，对于在药物性心动过缓的跳动心脏上进行的吻合质量，人们提出了合理的担忧，并且该技术的长期结果仍然存在疑问。循环辅助装置和机械稳定装置的联合使用有望通过允许左心室减压、使心脏回缩和旋转，并有望进一步改善结果，从而扩大冠状动脉的手术入路。在广泛应用之前，应证明侵入性较小的冠状动脉手术与传统CABG一样有效和安全。
