Early and Midterm Results of No-Touch Aorta Multivessel Small Thoracotomy Coronary Artery Bypass Grafting: A Propensity Score-Matched Study

Ziankou, Aliaksandr; Ostrovsky, Yuri

doi:10.1177/155698451501000407

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…The length of the incision with this innovative technique was drastically reduced, from 5 to 10 to nearly 2 to 3 inches 3 . Since then, many groups have reported their experience in this operation, including data for early and long‐term graft patency 4–6,10–13 . One of the most prominent papers on the subject was published by Ruel et al 7 in 2014.…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive multivessel coronary artery bypass grafting (MIM CABG) is conceptually similar to the conventional off‐pump CABG, which implies that both arterial and venous grafts can be situated with usual configurations. Moreover, some authors report the significant experience in no‐touch aorta multiple arterial revascularization 4–6 …”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive multivessel coronary bypass surgery: Angiographic patency data

Снегирев¹,

Пайвин

Denisyuk³

et al. 2020

J Card Surg

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Objective Minimally invasive multivessel coronary artery bypass grafting (MIM CABG) has demonstrated its safety, effectiveness and high rate of reproducibility. However, minithoracotomy CABG is still rarely performed. In this study, we retrospectively analyze the CT‐angiographic graft patency rates for the patients subjected to this operation. Methods A total of 245 patients were subjected to MIM CABG by a left minithoracotomy approach between 2014 and 2018. The left internal thoracic artery (LITA) harvesting, proximal, and distal anastomoses were performed under direct vision. The patients then underwent 128‐slice computed tomography coronary angiography (CTA). The angiographic results were obtained for 127 (51.8%) patients (the follow‐up period of 31.1 ± 7.8 months, from 15 to 45 months). Of the total patients, 204 (83.2%) were followed clinically during the time period from 12 to 56 months. Results Complete revascularization was performed for all the patients. The mean number of grafts was 2.6 ± 0.5. The perioperative mortality was 0.4% (1 patient). There were two conversions to sternotomy (0.8%), four reopenings for bleeding (1.6%), three myocardial infarctions (1.2%), and one stroke (0.4%). Twenty‐two patients (9.0%) received transfusions. The long‐term mortality was 4.4% (nine patients). Three patients (1.5%) suffered from a stroke during the follow‐up period. For five patients (2.4%), repeat revascularization was necessary. For the examined patients, the overall graft patency rate was 89.8%, the LITA graft patency rate was 98.4%, the radial artery patency was 100%, and the saphenous vein graft patency was 84.0%. Conclusions MIM CABG allows complete surgical revascularization with excellent clinical outcomes and promising angiographic graft patency rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally invasive multivessel coronary bypass surgery: Angiographic patency data

Снегирев¹,

Пайвин

Denisyuk³

et al. 2020

J Card Surg

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“…Считаем важным техническим моментом, особенно у пожилых пациентов, минимизацию манипуляций с восходящим отделом аорты, которая часто атеросклеротически изменена -для этого использовали артериальные кондуиты (левая и правая внутренние грудные артерии). При множественной реваскуляризации миокарда и использовании аутовенозных шунтов неизбежным было выполнение пристеночного отжатия аорты, что из-за возможного повреждения мягких и твердых атероматозных и кальцинированных бляшек могло стать причиной острого нарушения мозгового кровообращения [21]. Вместе с тем в группе с ИК помимо бокового отжатия аорты требуется канюляция и поперечное отжатие восходящей аорты, что еще больше увеличивает этот риск.…”

Section: Discussionunclassified

Comparative analysis of the immediate results of the off-pump versus on-pump myocardial revascularization in the elderly patients

et al. 2019

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Aim: To evaluate efficacy and safety of surgical myocardial revascularization with two internal thoracic arteries in the elderly patients and to identify special aspects and immediate results of the interventions on a working heart and with the use of cardiopulmonary bypass and on a working heart.Materials and methods: This retrospective single center study included patients over 65 years of age with multivessel coronary artery disease who underwent coronary artery bypass grafting with two internal thoracic arteries in a working heart without cardiopulmonary bypass at the Federal Clinical Center of High Medical Technologies of FMBA of Russia from 2015 to 2017 (the study group, n=50) and with cardiopulmonary bypass and cardioplegia (the comparison group, n=51). We analyzed demographic characteristics, preoperative state severity, and special aspects of myocardial damage, operational parameters, rates, and structure of postoperative complications.Results: None of the patients died. Median intraoperative parameters in the study group were better than those in the comparison group: blood loss, 300 vs. 800 mL (p<0.001), duration of the surgery, 190 and 240 min (p<0.001), duration of mechanical ventilation, 3 and 5 hours (p<0.001), respectively. Early postoperative acute renal failure was less frequent in the patients who had undergone surgery without cardiopulmonary bypass (median serum creatinine levels 90 vs. 125 µmol/L (p<0.001)). Postoperative complications were observed in the group of patients operated with cardiopulmonary bypass: three cases of acute cerebrovascular accidents (stroke) and one deep wound infection of the sternum. Mean duration of the hospital stay in the patients operated on a working heart without the use of cardiopulmonary bypass was 7 days versus 9 in the comparison group.Conclusion: Myocardial revascularization without cardiopulmonary bypass is associated with lower rates of postoperative complications, decreased duration of the procedure, decreased blood loss, time on mechanical ventilation and acute renal failure rate, which all results in decreased duration of hospital stay. Bimammary myocardial revascularization without cardiopulmonary bypass could be the method of choice in the elderly patients.

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“…A case-matched study by Lapierre et al demonstrated that MIDCAB patients had a statistically significant shorter median hospital stay (5 days vs. 6 days) and a faster median time to return to total physical activity (12 days vs. 36 days) compared to off-pump coronary artery bypass (OPCAB) [44]. In addition, Ziankou et al indicated that patients undergoing minimally invasive CABG had shorter hospital stays (4.5 days vs. 7.5 days) and a decreased median time to resume complete activities by four times (14 days vs. 56 days) when compared to those undergoing CABG through MS [45].…”

Section: Minimally Invasivementioning

confidence: 99%

Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

Ilcheva,

Risteski,

Tudorache

et al. 2023

JCM

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Over the past two decades, minimally invasive cardiac surgery (MICS) has gained a significant place due to the emergence of innovative tools and improvements in surgical techniques, offering comparable efficacy and safety to traditional surgical methods. This review provides an overview of the history of MICS, its current state, and its prospects and highlights its advantages and limitations. Additionally, we highlight the growing trends and potential pathways for the expansion of MICS, underscoring the crucial role of technological advancements in shaping the future of this field. Recognizing the challenges, we strive to pave the way for further breakthroughs in minimally invasive cardiac procedures.

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Early and Midterm Results of No-Touch Aorta Multivessel Small Thoracotomy Coronary Artery Bypass Grafting: A Propensity Score-Matched Study

Cited by 3 publications

References 12 publications

Minimally invasive multivessel coronary bypass surgery: Angiographic patency data

Minimally invasive multivessel coronary bypass surgery: Angiographic patency data

Comparative analysis of the immediate results of the off-pump versus on-pump myocardial revascularization in the elderly patients

Beyond Conventional Operations: Embracing the Era of Contemporary Minimally Invasive Cardiac Surgery

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