VIDEO-ASSISTED CORONARY-ARTERY BYPASS-GRAFTING DURING HYPOTHERMIC FIBRILLATORY ARREST

Background. Hypothermic fibrillatory arrest without aortic cross-clamp ing is a technique for quieting the heart during coronary artery bypas s grafting. This report reviews the preliminary results with this tech nique in 4 patients having video-assisted coronary artery bypass graft ing. Methods. Four male patients 28.5 to 64.5 years old (mean age, 45. 4 years) underwent operation for unstable angina. With video-assisted techniques, coronary artery bypass grafting was performed through a le ft anterior minithoracotomy with femoral-femoral cardiopulmonary bypas s without cross-clamping the aorta. The myocardium was protected by co ntinuous coronary perfusion during hypothermic fibrillatory arrest. Re sults. A left internal thoracic artery graft was anastomosed to the le ft anterior descending coronary artery in each patient. The posterior descending branch of the right coronary artery was grafted with a pedi cled right gastroepiploic artery in 1 patient. The duration of cardiop ulmonary bypass was 72 to 127 minutes (mean duration, 92 +/- 21 minute s). The postoperative course of each patient was uneventful. Follow-up (range, 3.9 to 5.8 months; mean follow-up, 4.9 months) was complete f or all patients. There were no late deaths. Coronary angiography showe d patent grafts. All patients were in New York Heart Association funct ional class I or II (mean class, 1.25). Conclusions. Hypothermic fibri llatory arrest is a simple and effective method of quieting the heart, thereby providing a motionless operative field for video-assisted cor onary artery bypass grafting. (C) 1997 by The Society of Thoracic Surg eons.