MINIMALLY INVASIVE SURGICAL TECHNIQUE FOR THE TREATMENT OF MULTIVESSEL CORONARY-ARTERY DISEASE

Background. To avoid sternotomy-related complications after cardiac op erations, we developed a minimally invasive surgical technique for the treatment of multivessel coronary artery disease. Methods. From Novem ber 1996 to May 1997, 39 patients (age range, 50 to 78 years) with cor onary artery disease were treated with the use of this technique. Thro ugh a small (6- to 9-cm) left lateral chest incision in the third inte rcostal space, the left internal mammary artery was harvested directly . With the use of cardiopulmonary bypass and cardioplegic arrest in al l patients except 1, the left internal mammary artery was anastomosed to the left anterior descending artery. In addition, vein grafts and o ther arterial conduits were used for revascularization of the other co ronary arteries. Results. There were no intraoperative complications. All the patients survived the procedure and had an uneventful postoper ative course. Wound complications occurred in 2 patients. The median ( +/- standard error of the mean) hospital stay was 6 +/- 1 days. Conclu sions. This technique combines minimally invasive surgical conditions with the safety standards of routine cardiac operations. With the use of this approach, even extensive coronary artery disease can be treate d. (C) 1998 by The Society of Thoracic Surgeons.