MINIMALLY INVASIVE CORONARY SURGERY IN WOMEN

Objective To evaluate the minimally invasive surgery in coronary arter y bypass grafting and the feasibility for revascularization of triple Vessel coronary artery disease. Methods Nine female patients, aged 49. 1 to 81.6 years (mean 64.3), were operated on for triple vessel diseas e through minimally invasive surgical techniques. The surgeries were p erformed through limited left parasternal incision under femorofemoral extracorporeal circulation. The myocardium was protected by antegrade infusion of cold blood cardioplegic solution while the aorta was cros s-clamped. Under direct vision, the left saphenous vein grafts were co nnected sequentially to the diagonal branch, obtuse marginal branch an d posterior descending branch, and the left internal thoracic arterial graft was anastomosed to the left anterior descending artery in each patient. Results The number of distal anastomoses was 3 to 4 with a me an of 3.7. The aortic crossclamp time was 52 to 130 minutes (82 +/- 25 minutes). The duration of extracorporeal circulation was 78 to 151 mi nutes (115 +/- 29 minutes). The postoperative course was uneventful in all patients. The postoperative length of stay was 4 to 12 days (7.2 +/- 2.0 days). Follow-up (4.2 to 8.7 months, mean 6.4) was complete in all patients and there were no late deaths or angina. Coronary angiog raphy of 2 patients showed patent grafts. All patients were satisfied with the good cosmetic healing of the incision. Conclusion Our experie nce demonstrates that minimally invasive surgery in coronary artery by pass grafting is technically feasible and may be an alternative approa ch in surgical revascularization of triple vessel coronary artery dise ase, especially in female patients.