Innovative Approach – Minimally Invasive Multivessel Coronary Grafting Through a Left Anterior Thoracotomy

Babliak, Oleksandr; Diagnostic,; Demianenko, Volodymyr; Babliak, Dmytro; Melnyk, E. A.; Revenko, Katerina; Stohov, Oleksii

doi:10.25040/ntsh2019.01.06

Cited by 2 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Багатосудинне аорто-коронарне шунтування в умовах лівої передньої мініторакотомії за методикою TCRAT (Total Coronary Revascularization via Left Anterior Thoracotomy) [17][18][19] рутинно проводиться в нашій установі, починаючи з липня 2017 року. Зазначена методика застосовується у всіх пацієнтів незалежно від кількості анастомозів, якості та розташування коронарних артерій, індексу маси тіла, віку, наявності супутніх захворювань, прогнозованого післяопераційного ризику.…”

Section: вступunclassified

“…Ці пацієнти були виключені із дослідження. У решти 349 (97,7 %) пацієнтів була проведена повна реваскуляризація міокарда через ліву передню мініторакотомію за методикою TCRAT [17][18][19] (з використанням апарата штучного кровообігу, периферичною канюляцією та в умовах кров'яної кардіоплегії). В усіх пацієнтів було отримано інформовану згоду на проведення операції та обробку персональних даних.…”

Section: матеріали та методи пацієнтиunclassified

See 1 more Smart Citation

The Influence of Risk Factors on Perioperative Results of Multivessel Coronary Artery Bypass Grafting Through the Left Anterior Minitoracotomy

Babliak

Demianenko

Babliak

et al. 2021

Transplant. artif. organs

View full text Add to dashboard Cite

Multivessel coronary artery bypass grafting (CABG) through the left anterior minitoracotomy using the technique of total coronary revascularization via left anterior thoracotomy (TCRAT) is routinely performed in our institution since July 2017. This technique is used in all patients regardless of the number of anastomoses, quality and location of coronary targets, body mass index, age, comorbidities and predicted postoperative risk. The aim. To present the results of 349 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive CABG. To compare perioperative outcomes of minimally invasive CABG in patients with existent risk factors for CABG and to identify possible contraindications to the use of this CABG technique. Materials and methods. From July 2017 to January 2020, 357 consecutive patients were underwent multivessel CABG at our institution. Eight (2.3%) patients in whom CABG was performed through the median sternotomy were excluded from the study. The remaining 349 (97.7%) patients underwent complete myocardial revascularization through the left anterior minitracotomy using TCRAT technique (peripheral cannulation for cardiopulmonary bypass (CPB), cold blood cardioplegia). All the patients were divided into groups according to the presence of risk factors (obesity, old age, diabetes, risk of postoperative mortality greater than 2.0 calculated by EuroSCORE II scale) to analyze the impact of these factors on intraoperative and postoperative parameters. Results. Intra- and postoperative parameters in patients of all groups were within safe limits. There was no statistically significant difference between the patients older and younger than 70. Diabetic and obese patients had a longer total operation time (on average by 5%, p = 0.003 and 7%, p = 0.019, respectively), CPB time (on average by 8%, p = 0.002 and 11%, p = 0.0001, respectively) and intensive care unit stay (on average by 15%, p = 0.004 and 17%, p = 0.013, respectively) compared to the patients without these conditions. The patients with EuroSCORE II risk more than 2.0 were had longer main phase of the operation (on average by 12 minutes, i.e. 8%, p = 0.013), they required longer ventilation time (by 27%, p = 0.036), longer stay in the intensive care unit (by 23%, p = 0.0004), had a longer hospital stay (by 15%, p < 0.0001), they were more likely to have acute kidney damage that required hemodialysis, and mortality was observed only in this group of patients. However, even in this group of severe patients, the incidence of complications and mortality did not exceed the predicted rates. Conclusions. The technique of minimally invasive CABG through the left anterior thoracotomy allow the possibility to avoid median sternotomy in 97.7% of patients with multivessel coronary artery disease. The technique of minimally invasive multivessel CABG through the left anterior thoracotomy is universal and does not require patient selection, because it can be used effectively and safely regardless of obesity, diabetes or old age. This technique can be performed in patients with any EuroSCORE II rate without the mortality rate increase.

show abstract

Section: вступunclassified

Section: матеріали та методи пацієнтиunclassified

The Influence of Risk Factors on Perioperative Results of Multivessel Coronary Artery Bypass Grafting Through the Left Anterior Minitoracotomy

Babliak

Demianenko

Babliak

et al. 2021

Transplant. artif. organs

View full text Add to dashboard Cite

show abstract

“…У решти 343 пацієнтів проведено повну реваскуляризацію міокарда через ліву передню мініторакотомію з використанням апарату штучного кровообігу, периферичною канюляцією та в умовах кров'яної кардіоплегії [10][11][12]. У 83 (24,2 %) пацієнтів виконано реваскуляризацію міокарда за допомогою кількох артеріальних кондуїтів: ЛВГА самостійно (секвенційні анастомози ЛВГА) -6 (1,7 %) пацієнтів), ЛВГА разом з лівою променевою артерією -70 (20,4 %) пацієнтів, ЛВГА разом з ПВГА -7 (2 %) пацієнтів, а також вени в разі потреби й за відсутності критичних стенозів.…”

Section: український журнал серцево-судинної хірургії 2020 2 (39)unclassified

Minimally Invasive Coronary Bypass Grafting as a Standard Approach for Myocardial Revascularization

Babliak

Demianenko

Babliak

et al. 2020

ujcvs

Self Cite

View full text Add to dashboard Cite

Background. Minimally invasive cardiac surgery is becoming more widespread. The aim of the study was to evaluate the outcomes in 343 consecutive patients with isolated multivessel coronary artery disease who underwent minimally invasive coronary revascularization. Materials and methods. From July 2017 to December 2019 we performed total coronary revascularization via left anterior minithoracotomy (TCRAT) in 343 consecutive patients with isolated multivessel coronary artery disease. In 83 (24.2%) of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). Cardiopulmonary bypass (CPB), aortic cross-clamping and blood cardioplegia were used in all patients. The patients were divided into two groups, uniarterial and multiarterial, to compare and analyze perioperative parameters. Results. No cases of postoperative myocardial infarction, surgically induced infection, or conversion to sternotomy were observed in any of the study groups. Total perioperative mortality was 0.58% (2 patients). Total operation time (290.6±48 [205; 495] versus 259.4±53.3 [165; 590], p=0.0001) and aortic cross-clamping time (81.6±18.7 [40; 122] versus 67±18 [35; 146], p<0.0001) were longer in patients with multiarterial revascularization compared to those with uniarterial revascularization. The patient’s mean age in the multiarterial group was 7.4 years less than in the uniarterial group. The mean hospital stay was 0.5 days shorter in the multiarterial group. Conclusions. The technique of minimally invasive coronary artery bypass grafting via left anterior thoracotomy avoids median sternotomy in 97.7% of patients. Both strategies for minimally invasive myocardial revascularization (multiarterial and uniarterial) are safe and effective with comparable perioperative outcomes and a total mortality of 0.58%.

show abstract

Innovative Approach – Minimally Invasive Multivessel Coronary Grafting Through a Left Anterior Thoracotomy

Cited by 2 publications

References 17 publications

The Influence of Risk Factors on Perioperative Results of Multivessel Coronary Artery Bypass Grafting Through the Left Anterior Minitoracotomy

The Influence of Risk Factors on Perioperative Results of Multivessel Coronary Artery Bypass Grafting Through the Left Anterior Minitoracotomy

Minimally Invasive Coronary Bypass Grafting as a Standard Approach for Myocardial Revascularization

Contact Info

Product

Resources

About