LEFT ANTERIOR DESCENDING CORONARY-ARTERY BYPASS-GRAFTING THROUGH MINIMAL THORACOTOMY

Background. In recent years, minimally invasive direct coronary artery bypass grafting has emerged as a valid tool for revascularization in a select group of patients with severe lesions of the left anterior de scending coronary artery. Here we report the clinical results using tw o devices designed by us to facilitate the harvesting of the left inte rnal mammary artery up to its origin and to occlude and stabilize the left anterior descending coronary artery while placing the anastomosis . Methods. From January 1996 to January 1998, 122 patients underwent m inimally invasive direct coronary artery bypass grafting in the Depart ment of Cardiac Surgery, Favaloro Foundation. One hundred twelve patie nts received a single left internal mammary artery-left anterior desce nding coronary artery bypass graft, and in 10 patients, an additional bypass graft was performed. Results. Most patients were discharged on day 2 or 3 after the procedure. Three patients (2.5%) had a perioperat ive myocardial infarction. The overall hospital mortality rate was 3.3 % (4 patients). Conclusions. The combination of team experience, more careful dissection of the left internal mammary artery up to its origi n, and use of the stabilizer-occluder and interrupted suture technique for the anastomosis has markedly improved our results.