Ministernotomy in Off-Pump Coronary Artery Bypass Surgery

Abstract

ABSTRACT:BACKGROUND:Ministernotomy is a new suergical producer which is decrease invasiveness of suergical treatment coronary arteries insuffecince and there are several advantages over standard poceduer.OBJECTIVE: Patients with isolated lesions of the proximal left anterior descending artery (LAD) have been demonstrated to benefit more from surgical treatment than percutaneous coronary interventions (PCI). However, with the less invasiveness of PCI, the majority of the patients have been referred for this latter procedure. We report here on the inferior ministernotomy approach for the treatment of patients with single LAD lesions, with off-pump anastomosis of the left internal thoracic artery graft.METHOD: Fourteen patients, consecutively operated on using this technique with the LITA graft anastomosed to the LAD, were examined. The mean age of the patients was 56.7 ± 10.1 years. The length of the skin incision varied from 8 to 10 cm and only the distal sternum was split lengthwise. The anastomosis was facilitated with the use of an Octopus-3 stabilizer .RESULTS: All patients had satisfactory postoperative outcomes, the length of postoperative hospital stay ranged from 2 to 6 days (median 3 days). No ECG changes or enzymatic rises were seen in this series. One patient was re-admitted for wound infection.CONCLUSION: The ministernotomy approach allows safe accomplishment of off-pump LAD grafting, providing the long-term benefits of using the LITA.KEY WORDS: ministernatomy,left internal thoracic artery(LITA),off-pump.