Coronary surgery with minimun access and cardiopulmonary bypass

From October 1997 to March 1998 we operated on seven patients with minimal incision, cardiopulmonary by-pass with femoral cannulation and antegrade bl ood cardioplegic arrest using the "endo-clamp" (Heartport Inc.). The seven patients with isolated severe lesions of the left anterior descending under went a left internal thoracic artery graft under direct vision. Three had s aphenous vein coronary bypass grafts performed to the diagonal (2) and obtu se marginal branches of the left, coronary artery. The median cardiopulmonary bypass duration was 75 minutes (30-230) and the aortic occlusion time was 33 minutes (10-117). No major complications occur red and only two minor ones were noted. The median intensive care unit stay was 2 days (1 to 4) and the total hospital stay was 6.5 days (3 to 13). Al l the patients are in NYHA FC I, without treatment and a follow up of 3 to 6 months after the surgery. With this method of myocardial revascularization with minimal incision and cardiopulmonary bypass the sternotomy-related complications can be avoided, the intensive care unit and hospital stay can be reduced with better conva lescence for the selected patients. We believe that this technique is a val id option for an increasing number of patients.