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DOI: 10.1055/s-0041-1739186
Bilateral Internal Thoracic Artery Minimally Invasive CABG Management in COPD
Abstract
Background Off-pump multi-arterial minimally invasive coronary surgery via anterolateral mini-thoracotomy has become a feasible and safe procedure.
Case Description We report on a 61-year-old patient with a coronary one-vessel disease with severely stenotic left anterior descending artery and diagonal branch, additionally suffering from chronic obstructive pulmonary disease with severely impaired lung function. Using a fan technique allowing for double lung ventilation, the patient was successfully operated grafting both internal thoracic arteries via a left anterolateral mini-thoracotomy.
Conclusion Anaortic, minimally invasive off-pump coronary artery bypass grafting is an excellent technique to achieve myocardial revascularization with both internal thoracic arteries even in patients with impaired lung function.
Keywords
coronary artery bypass grafting - off-pump CABG - LITA - RITA - minimally invasive cardiac surgery (MICS) - chronic obstructive pulmonary disease (COPD)Authors' Contributions
A.K.A. contributed toward drafting the manuscript and visualization. A.L. did the review, editing, and collected the resources. A.A. contributed toward the conception of work, performed the operation, and critical revision of the article.
Publication History
Received: 27 June 2021
Accepted: 20 July 2021
Article published online:
02 February 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Lapierre H, Chan V, Sohmer B, Mesana TG, Ruel M. Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study. Eur J Cardiothorac Surg 2011; 40 (04) 804-810
- 2 Albert A, Assmann A, Assmann AK, Aubin H, Lichtenberg A. Operative Techniques in Coronary Artery Bypass Surgery—An Illustrated Guide to Personalized Therapy. London: Springer International Publishing; 2021: 54-55
- 3 Gaudino M, Bakaeen F, Davierwala P. et al. New strategies for surgical myocardial revascularization. Circulation 2018; 138 (19) 2160-2168
- 4 Davierwala PM, Verevkin A, Sgouropoulou S. et al. Minimally invasive coronary bypass surgery with bilateral internal thoracic arteries: Early outcomes and angiographic patency. J Thorac Cardiovasc Surg 2021 Oct;162(4):1109-1119.e4. doi: 10.1016/j.jtcvs.2019.12.136. Epub 2020 Apr 8
- 5 Benedetto U, Raja SG, Albanese A, Amrani M, Biondi-Zoccai G, Frati G. Searching for the second best graft for coronary artery bypass surgery: a network meta-analysis of randomized controlled trials. Eur J Cardiothorac Surg 2015; 47 (01) 59-65 , discussion 65
- 6 Buttar SN, Yan TD, Taggart DP, Tian DH. Long-term and short-term outcomes of using bilateral internal mammary artery grafting versus left internal mammary artery grafting: a meta-analysis. Heart 2017; 103 (18) 1419-1426
- 7 Taggart DP, Altman DG, Gray AM. et al. ART Investigators. Randomized trial of bilateral versus single internal-thoracic-artery grafts. N Engl J Med 2016; 375 (26) 2540-2549
- 8 Albert A, Ennker J, Hegazy Y. et al. Implementation of the aortic no-touch technique to reduce stroke after off-pump coronary surgery. J Thorac Cardiovasc Surg 2018; 156 (02) 544-554.e4