Toracotomia esquerda para reoperação de revascularização miocárdica

Duarte, Carlos Sérgio Luna Gomes; Neto, Fernando Ribeiro de Moraes; Moraes, Carlos R.

doi:10.1590/s0102-76382007000300011

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…Off-pump redo CABG revascularising the Cx and its branches via a left posterolateral thoracotomy in carefully selected patients presents dramatically improved consequences as a result of avoiding median resternotomy and CPB 5,13,14…”

Section: Discussionmentioning

confidence: 99%

Redo off-pump coronary artery bypass grafting via a left thoracotomy : cardiovascular topic

Duvan¹,

Ates²,

Onuk³

et al. 2015

CVJA

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SummaryBackgroundIn this study, we retrospectively reviewed our experience in a meticulously selected group of patients undergoing redo off-pump coronary artery bypass graft (CABG) surgery from the descending aorta to the circumflex artery (Cx) and its branches.MethodsBetween January 2001 and October 2013, 32 patients at our hospital underwent redo off-pump CABG from the descending aorta to the Cx and its branches via a left posterolateral thoracotomy. Of these patients, 27 were male (84.3%) and five were female (15.7%), with a mean age of 61.66 ± 8.63 years. All patients had a patent left internal thoracic artery-to-left anterior descending coronary artery (LITA–LAD) anastomosis. Thoracotomy was performed through the fifth intercostal space. The saphenous vein or radial artery was prepared as a graft at the same time as the left posterolateral thoracotomy from the contralateral extremity, without any positional problem.ResultsThe main reasons for surgery in this group of patients were new lesion formation in 19, graft occlusion in six, and both in seven patients. The average operating time was 143.90 ± 36.93 minutes, respiratory assist time was 5.08 ± 1.88 hours, intensive care unit (ICU) stay was 21.3 ± 4.41 hours and hospital stay was 5.06 ± 2.74 days. Thirty-eight bypasses were performed. The follow-up period was 56.17 ± 39.2 months. Six patients were lost in the follow-up period and four patients died. Twenty-two were alive and free of cardiac problems.ConclusionRedo off-pump CABG via a left posterolateral thoracotomy provided a safe and effective surgical approach with lower rates of postoperative morbidity and mortality in patients who required revascularisation of the Cx and its branches.

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Section: Discussionmentioning

confidence: 99%

Redo off-pump coronary artery bypass grafting via a left thoracotomy : cardiovascular topic

Duvan¹,

Ates²,

Onuk³

et al. 2015

CVJA

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Early cardiac contractility outcome of reoperative coronary artery bypass grafting using right gastroepiploic artery

Shiraishi

Kimura

Yamaguchi

2021

Journal of Cardiac Surgery

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Background and aim of the study Reoperative coronary artery bypass grafting (redo CABG) still carries higher mortality and increased morbidity compared with primary CABG. In this study, we retrospectively reviewed our operative outcome of redo CABG to evaluate the impact of the left anterolateral thoracotomy approach using the right gastroepiploic artery (RGEA). Methods Between 1994 and 2020, 11 patients (mean age 60.3 ± 13.1 years; nine men, two women) underwent isolated redo CABG using the RGEA via the left anterolateral thoracotomy. Results The mean duration from the initial CABG was 128.3 ± 88.4 months. Redo CABG was performed because of graft occlusion in six patients (54.5%), graft stenosis in one patient (9.1%), and progressive disease of previously ungrafted vessels in four patients (36.4%). The total number of bypasses using RGEA (including Y‐composite vein grafts) was 16 (four left anterior descending branches, two diagonal branches, five circumflex branches, five right coronary arteries). No residual graft injury, major comorbidity, or in‐hospital death was observed. Changes in echocardiographic values before and after redo CABG were 210.9 ± 48.2 ml and 175.0 ± 41.4 ml in left ventricular end‐diastolic volume, 130.2 ± 49.2 ml and 94.4 ± 33.0 ml in left ventricular end‐systolic volume, and 45.6 ± 11.0% and 52.2 ± 10.7% in left ventricular ejection fraction, respectively. These parameters significantly improved after redo CABG. Conclusions Redo CABG with RGEA grafting via the left anterolateral thoracotomy approach is a safe and effective surgical procedure especially in improving cardiac contractility in patients who required revascularization.

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Redo off-pump coronary artery bypass grafting via left thoracotomy

Duvan

Kurtoğlu

Ates

et al. 2013

J Cardiothorac Surg

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Toracotomia esquerda para reoperação de revascularização miocárdica

Abstract: An off-pump redo-CABG through a left posterolateral thoracotomy may reduce risks attributable to resternotomy in patients who met the selection criteria.

Cited by 5 publications

References 13 publications

Redo off-pump coronary artery bypass grafting via a left thoracotomy : cardiovascular topic

Redo off-pump coronary artery bypass grafting via a left thoracotomy : cardiovascular topic

Early cardiac contractility outcome of reoperative coronary artery bypass grafting using right gastroepiploic artery

Redo off-pump coronary artery bypass grafting via left thoracotomy

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