Multi-vessel coronary artery bypass grafting with the Port-Access system

Multi-vessel coronary artery bypass grafting through a left anterior small thoracotomy is a rarely performed procedure due to the impaired accessibili ty of the aorta as well as the complete coronary anatomy. Because of additi onal contraindications in using the Port-Access(TM) system, this surgical m ethod is not well recognized among the numerous techniques in minimally inv asive cardiac surgery. Our aim was to identify a patient population, for which this procedure is s uitable, and to evaluate quality and clinical patient outcome. After an initial experience of 28 patients, we have found excellent quality of anastomoses, patency rate of grafts, and clinical outcome. These result s do not differ from conventional surgical methods. Multi-vessel Port-Acces s revascularization is possible in a large patient population. However, a s ubstantial learning curve as well as longer operating times have to be cons idered.