Rk. Wolf et al., Thoracoscopic mammary artery mobilization in redo minimally invasive coronary bypass operations, ANN THORAC, 68(4), 1999, pp. 1540-1541
Citations number
4
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. It has been stated that thoracoscopic internal thoracic artery
(ITA) mobilization is not recommended in the redo minimally invasive direct
coronary artery bypass (FI MIDCAB) situation, presumably because adhesions
from the previous coronary artery bypass grafting operation may preclude a
thoracoscopic approach. However, there are advantages to thoracoscopic ITA
mobilization in MIDCAB that could also be realized in the redo situation.
Methods. In 200 MIDCAB procedures over the last 3 and a half years, 11 pati
ents, ages 49-83 (mean 69), were identified as having undergone an attempte
d ITA mobilization in a redo situation.
Results. Thoracoscopic ITA mobilization was successful in 9 out of 11 patie
nts (81%). One patient had complete pleural symphysis precluding this appro
ach, and 1 patient had poor mammary now after harvest and this conduit was
not used. Both failures were in female octogenarians.
Conclusions. To realize the advantages of a tharacoscopic ITA mobilization
MIDCAB, both right and left thoracoscopic ITA mobiIization can safely be pe
rformed in the redo situation. Thoracic adhesions precluding a thoracoscopi
c approach were encountered in only 1 of 11 redo coronary artery bypass gra
fting patients. (C) 1999 by The Society of Thoracic Surgeons.