MINIMALLY INVASIVE APPROACH FOR CORONARY-ARTERY BYPASS-SURGERY

Forty-two patients, 33 male and 9 female, aged 35.7 to 81.6 years old (mean 62.7), were operated on for left main and/or triple vessel coron ary artery disease by using minimally invasive cardiac surgical techni ques. A myocardial infarction had occurred in 26 patients (61.9%). The left ventricular ejection fraction ranged from 17 to 83% (52+/-22). T he surgeries were performed through left parasternal minithoracotomy ( 8 to 12 cm in length) under femoro-femoral or aorto-atrial cardiopulmo nary bypass. The myocardium was protected by blood cardioplegic soluti on with the aorta crossclamped. Under direct vision, average 3.8 dista l anastomoses were performed in each patient, with the saphenous vein grafts and the left internal thoracic arterial graft. The aortic cross clamp time was 62 to 137 min (80+/-15). The duration of cardiopulmonar y bypass was 88 to 168 min (115+/-24). The postoperative course was un eventful in all patients. Follow-up (1.0 to 5.6 months, mean 2.9) was complete in all patients and there were no late deaths or angina. Coro nary angiography of ten patients showed patent grafts. Our experience demonstrates that minimally invasive cardiac surgery during cardiopleg ic arrest is technically feasible and can be performed in coronary art ery disease safely and effectively for complete revascularization. (C) 1997 Elsevier Science Ireland Ltd.