Microsurgical technique in coronary bypass surgery: possibilities, perspectives and limitations

Microscope-Assisted Coronary Artery Bypass Grafting: Technique and Results

“…The common field of view of the operator and assistant when working with an operating microscope, and the ability to adequately correct the magnification according the diameter of the target coronary artery allow to identify and prevent in time several most common technical errors in the execution of a distal anastomosis, such as the capture of opposite walls in the suture, fragmentation of the atherosclerotic plaque with its screwing in the lumen, trauma to the posterior wall of the coronary artery, etc. [ 4 , 8 , 12 ] .…”

“…A significant optical magnification makes it possible to compare vessel walls very accurately, without the need for additional sutures. It significantly reduces the risk of developing hemodynamically significant stenosis along the anastomosis line [ 4 , 6 , 11 ] .…”

“…The use of the surgical microscope for CABG allows the restoration of blood flow in the coronary arteries with a diameter of less than 1.5 mm. Enough magnification and microsurgical technique allow complete myocardial revascularization in patients with a small diameter of the coronary arteries and reduce the rate of refusals to operate for this reason [ 4 , 7 , 9 , 13 ] .…”

“…The microscope-assisted CABG is a special technique for direct myocardial revascularization by the operating microscope using special equipment and atraumatic sutures. This method allows the complete elimination of technical errors during distal anastomoses and can be used to improve the outcomes and quality of the conventional surgical technique [ 4 ] .…”

Perioperative predictors of early silent coronary graft occlusion after direct myocardial revascularisation

“…Работая в едином поле зрения операционного микроскопа и оптимально корригируя степень оптического увеличения, хирурги имеют возможность своевременно выявить и предотвратить случайные подхваты интимы в шов, фрагментацию атеросклеротической бляшки с ее вворачиванием в просвет КА, травму задней стенки КА, а также стенозирование области анастомоза и т. п. [8,[11][12][13][14]. Таким образом, дизайн исследования предполагал практически полное исключение риска технической ошибки при формировании дистального анастомоза и позволил выполнить поиск не связанных с хирургической техникой предикторов окклюзий шунтов.…”