Internal thoracic artery harvesting with a LigaSure device

Mavioglu, Ilhan

doi:10.1177/0218492319865437

Cited by 3 publications

(7 citation statements)

References 6 publications

(7 reference statements)

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“…The left internal thoracic artery (LITA) was then harvested using a skeletonized technique, with the side branches divided using a LigaSure Maryland Jaw (Medtronic, Dublin, Ireland). 4 The pericardium was then opened cephalad to the ascending aorta, parallel to the course of the left anterior descending artery (LAD), 2 to 3 cm above the phrenic nerve (Supplemental Video).…”

Section: Case Reportmentioning

confidence: 99%

Minimally Invasive Off-Pump Anaortic Complete Arterial Coronary Artery Bypass: How to Do It?

Mavioglu¹

2023

Innovations�(Phila)

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Minimally invasive direct coronary artery bypass has empowered coronary artery bypass grafting to compete with the appeal of percutaneous coronary procedures. Successful results of off-pump coronary artery bypass surgery and without touching the aorta have facilitated the development and use of minimally invasive methods. Multivessel coronary bypass surgery performed using a minimally invasive method through a small thoracotomy in the left chest with off-pump, anaortic, and all-arterial grafts is described step by step. Technical considerations, description of operation stages, and tips and pitfalls will be examined. A 64-year-old male patient with no known comorbidities except smoking revealed 3 vessels and a side vessel disease, and the heart team decided on surgical revascularization with a low-risk procedure. Experienced surgeons may perform this operation successfully, and the development of efficient simulation systems will increase its use.

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Section: Case Reportmentioning

confidence: 99%

Minimally Invasive Off-Pump Anaortic Complete Arterial Coronary Artery Bypass: How to Do It?

Mavioglu¹

2023

Innovations�(Phila)

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“…8 However, the LigaSure (Covidien Products; Medtronic) Exact Dissector tip has been used by the author (I. M.) to harvest ITA or BITA by sternotomy, and the Maryland Jaw tip to harvest ITA or BITA from the thoracotomy or port. 9 MAVIOGLU AND VALLELY | 4945…”

Section: Perioperative Detailsmentioning

confidence: 99%

“…After placing the retractor system, the LITA is then harvested using a skeletonized technique, with the side-branches divided using a LigaSure Maryland Jaw. 9 To harvest the RITA, silk slings are placed in the anterior mediastinal and thymic fat. Retraction can then be applied to expose the RITA for harvest.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The skeletonized ITA harvest using a harmonic scalpel (Ethicon Endo‐Surgery; CVD) has been demonstrated to be a safe and efficient technique 8 . However, the LigaSure (Covidien Products; Medtronic) Exact Dissector tip has been used by the author (I. M.) to harvest ITA or BITA by sternotomy, and the Maryland Jaw tip to harvest ITA or BITA from the thoracotomy or port 9 …”

Section: Introductionmentioning

confidence: 99%

“…A thoracotomy is performed through the fourth intercostal space. After placing the retractor system, the LITA is then harvested using a skeletonized technique, with the side‐branches divided using a LigaSure Maryland Jaw 9 . To harvest the RITA, silk slings are placed in the anterior mediastinal and thymic fat.…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive off‐pump anaortic coronary artery bypass (MACAB)

Mavioglu¹,

Vallely²

2022

Journal of Cardiac Surgery

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Background Minimally invasive direct coronary artery bypass has enabled coronary artery bypass graft to compete with the appeal of less invasive percutaneous coronary procedures. Favorable results of coronary artery bypass surgery performed without the use of cardiopulmonary bypass and without touching the aorta (anOPCAB) have enabled the development and use of minimally invasive methods. Methods Between 2016 and 2021, 112 patients underwent multivessel coronary bypass surgery performed using a minimally invasive method through a small thoracotomy in the left chest with off‐pump, anaortic, and all‐arterial grafts (Minimally Invasive Off‐Pump Anaortic Coronary Artery Bypass [MACAB]). Patient data were collected and retrospectively analyzed. Eight series from the literature using the multivessel mini‐OPCAB and MACAB technique were also evaluated. Results Collectively, from the literature, 2729 patients underwent an average of 2.4 bypasses with an early mortality rate of 0.7% and a stroke rate of 0.16%. In our MACAB case series, 112 patients underwent an average of 2.9 bypasses with a mortality rate of 1.8% and a stroke rate of 0%. Conclusion MACAB can be performed safely by experienced surgeons and reduces neurological injury and surgical trauma and may be a good alternative for multivessel stenting. Simulation systems are essential for its dissemination, and teams dedicated to coronary surgery—with subspecialty expertise—are necessary to achieve good outcomes.

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The Feasibility and Early Results of Multivessel Minimally Invasive Coronary Artery Bypass Grafting for All Comers

Demirsoy,

Mavioglu,

Dogan

et al. 2023

JCM

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Objectives: Cardiovascular surgery advancements have emerged with various minimally invasive approaches for treating multivessel coronary disease to improve outcomes and minimize the burden associated with conventional cardiac surgery. We present our clinical experience and minimally invasive coronary bypass techniques through minithoracotomy, which we apply without selection to patients who have decided to have elective surgery for multivessel isolated coronary artery disease. Methods: It consists of 230 consecutive patients operated by the same team with this method between July 2020 and September 2022. The patients were assigned to one of the two methods preoperatively to their accompanying comorbidities and operated on either with blood cardioplegia via 5 to 7 cm left anterior minithoracotomy, with on-pump clamped technique or without pump via left anterolateral minithoracotomy. Results: Mortality was observed in two of our patients (0.9%), but myocardial infarction was not observed in our patients in the early postoperative period. None of our patients required conversion to sternotomy (0%). Five patients’ needed reoperation from the same incision due to postoperative bleeding (2.2%), and atrial fibrillation developed in 17 patients in the postoperative period (7.4%). The mean number of bypasses was found to be 3.0 ± 0.9. Conclusions: Minimally invasive coronary artery bypass surgery via minithoracotomy can be routinely reproduced safely. More long-term results and more multicenter studies are needed for more widespread acceptance of the technique.

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Internal thoracic artery harvesting with a LigaSure device

Cited by 3 publications

References 6 publications

Minimally Invasive Off-Pump Anaortic Complete Arterial Coronary Artery Bypass: How to Do It?

Minimally Invasive Off-Pump Anaortic Complete Arterial Coronary Artery Bypass: How to Do It?

Minimally invasive off‐pump anaortic coronary artery bypass (MACAB)

The Feasibility and Early Results of Multivessel Minimally Invasive Coronary Artery Bypass Grafting for All Comers

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