Coulson A S, Bakhshay S A, Sloan T J
Dameron Hospital, Stockton, California 95203, USA.
Tex Heart Inst J. 1998;25(3):170-4.
We report 4 cases of redo coronary artery bypass grafting in which the circumflex coronary artery was successfully revascularized using a minimally invasive approach. In reoperative cases, it is easier to approach the circumflex coronary artery from the left side than from the front. Minimally invasive direct coronary artery bypass technology has made it possible to avoid using cardiopulmonary bypass. In our 4 cases, the revascularization procedure was performed via a small left thoracotomy, and without cardiopulmonary bypass. The patients made a good recovery and are free of angina 22 months after operation. We conclude that the thoracotomy approach provides the opportunity to avoid several hazards: a redo sternotomy, dissection of a hostile mediastinum, and manipulation of the heart.
我们报告了4例再次冠状动脉搭桥手术病例，其中采用微创方法成功实现了左旋支冠状动脉血运重建。在再次手术病例中，从左侧比从前方更容易接近左旋支冠状动脉。微创直接冠状动脉搭桥技术使得避免使用体外循环成为可能。在我们的4例病例中，血运重建手术通过左胸小切口进行，且未使用体外循环。患者恢复良好，术后22个月无心绞痛症状。我们得出结论，开胸手术方法提供了避免多种风险的机会：再次正中开胸、解剖充满粘连的纵隔以及对心脏的操作。
