“Keyhole” Coronary Artery Bypass Surgery

Abstract

ObjectiveThe objective of this study was to identify the utility of "keyhole" thoracotomy approaches to single-vessel coronary artery bypass surgery. Summary Background DataAlthough minimally invasive surgery is efficacious in a wide variety of surgical disciplines, it has been slow to emerge in cardiac surgery. Among 49 selected patients, the authors have used a mini-anterior keyhole thoracotomy (6 cm in length) combined with complete dissection of the internal mammary artery (IMA) pedicle under thoracoscopic guidance or directly through the keyhole incision to accomplish IMA coronary artery bypass grafting (CABG) to the left anterior descending (LAD) coronary artery circulation or to the right coronary artery (RCA). Methods

Bilateral anterior minithoracotomy with video assistance for lung volume reduction surgery and pulmonary metastasectomy

“…This approach uses similar logic as that of the recently reported technique of sternal sparing bilateral anterior thoracotomy for lung transplantation by Meyers and Patterson [7]. It also shares the minimally invasive nature of VATS-assisted "keyhole" coronary artery bypass approaches [5]. Recently, others have used a subxiphoid approach with VATS assistance to explore both hemithoraces simultaneously without sternal division [1].…”

Short- and Long-term Follow-up after Coronary Bypass Grafting for Single-vessel Coronary Artery Disease

“…The results, though currently inferior to those in conventional CABG, are nevertheless encouraging. As experience accumulates, "keyhole" CABG may become a reasonable alternative to sternotomy in recalcitrant single-vessel disease involving the proximal left anterior descending or the right coronary artery (12).…”

Minimally invasive port-access coronary artery bypass grafting with early angiographic follow-up: Initial clinical experience

“…The beating heart technique was initially performed through a median sternotomy [4][5][6][7][8] and later through a less invasive minithoracotomy. [9][10][11][12][13] Early results have been encouraging with the limited anterior small thoracotomy or MIDCAB procedure in select patients. The technique, however, appears to be applicable only to patients with single-vessel coronary disease, a group that accounts for a very small percentage of the overall cardiac surgical population.…”