On-pump coronary artery bypass grafting for the treatment of multivessel diseases via left anterolateral minithoracotomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HUANG Ritai , XU Genxing , WANG Yongyi , SHAN Jianggui , YANG Wengang ,  XUE Song

Department of Cardiovascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, P.R.China;

Corresponding author：

XUE Song, Email: xuesong64@163.com

Keywords：

Minithoracotomy; coronary artery disease; multivessel diseases; on-pump coronary artery bypass grafting

DOI：

10.7507/1007-4848.202011078

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the safety and follow-up results of on-pump coronary artery bypass grafting (CABG) for the treatment of multivessel diseases via left anterolateral minithoracotomy.Methods From January 2018 to March 2020, a total of 30 patients including 18 males and 12 females with an average age of 61.3±7.5 years having multivessel coronary heart diseases were treated in our hospital with on-pump CABG via left anterolateral minithoracotomy. Among them, 14 patients had three-vessel diseases and 16 patients had two-vessel diseases.Results There were 29 internal mammary artery-to-left anterior descending bypass grafts harvested in total while the rest were saphenous-vein bypass grafts. The average number of bypass vessels was 2.3±0.5. There was no perioperative death in the whole group, one patient underwent rethoracotomy due to hemorrhage, and one patient suffered acute renal insufficiency. The average time of postoperative tracheal intubation was 16.0±5.8 hours, and the postoperative ICU stay was 30.1±11.5 hours. Twenty five patients were followed up, including coronary CT angiography examinations at 6 months and 1 year after operation. Proximal anastomotic stenosis in one patient and distal anastomosis occlusion in one patient occurred.Conclusion On-pump CABG via left anterolateral minithoracotomy is safe for appropriately selected patients.

Citation： HUANG Ritai, XU Genxing, WANG Yongyi, SHAN Jianggui, YANG Wengang, XUE Song. On-pump coronary artery bypass grafting for the treatment of multivessel diseases via left anterolateral minithoracotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(2): 182-185. doi: 10.7507/1007-4848.202011078 Copy

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2.	Raja SG, Garg S, Rochon M, et al. Short-term clinical outcomes and long-term survival of minimally invasive direct coronary artery bypass grafting. Ann Cardiothorac Surg, 2018, 7(5): 621-627.
3.	Doenst T, Haverich A, Serruys P, et al. PCI and CABG for treating stable coronary artery disease: JACC review topic of the week. J Am Coll Cardiol, 2019, 73(8): 964-976.
4.	Nyström T, Sartipy U, Franzén S, et al. PCI versus CABG in patients with type 1 diabetes and multivessel disease. J Am Coll Cardiol, 2017, 70(12): 1441-1451.
5.	Diab M, Färber G, Sponholz C, et al. Coronary artery bypass grafting using bilateral internal thoracic arteries through a left-sided minithoracotomy: A single-center starting experience. Thorac Cardiovasc Surg, 2019, 67(6): 437-443.
6.	Sixt S, Aubin H, Kalb R, et al. Continuous procedural full-lung ventilation during minimally invasive coronary bypass grafting. Ann Thorac Surg, 2017, 104(6): 1994-2000.
7.	McGinn JT, Usman S, Lapierre H, et al. Minimally invasive coronary artery bypass grafting: dual-center experience in 450 consecutive patients. Circulation, 2009, 120(11 Suppl): S78-S84.
8.	Ruel M, Shariff MA, Lapierre H, et al. Results of the minimally invasive coronary artery bypass grafting angiographic patency study. J Thorac Cardiovasc Surg, 2014, 147(1): 203-208.
9.	Lemma M, Atanasiou T, Contino M. Minimally invasive cardiac surgery-coronary artery bypass graft. Multimed Man Cardiothorac Surg, 2013, 2013: mmt007.
10.	Kikuchi K, Une D, Kurata A, et al. Off-pump minimally invasive coronary artery bypass grafting using the bilateral internal thoracic arteries and the right gastroepiproic artery. Eur J Cardiothorac Surg, 2016, 49(4): 1285-1286.
11.	Lapierre H, Chan V, Sohmer B, et al. Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study. Eur J Cardiothorac Surg, 2011, 40(4): 804-810.
12.	Kikuchi K, Une D, Suzuki K, et al. Off-pump minimally invasive coronary artery bypass grafting with a heart positioner: Direct retraction for a better exposure. Innovations (Phila), 2015, 10(3): 183-187.
13.	Barsoum EA, Azab B, Shah N, et al. Long-term mortality in minimally invasive compared with sternotomy coronary artery bypass surgery in the geriatric population (75 years and older patients). Eur J Cardiothorac Surg, 2015, 47(5): 862-867.

1. Xu Y, Li Y, Bao W, et al. MIDCAB versus off-pump CABG: Comparative study. Hellenic J Cardiol, 2020, 61(2): 120-124.
2. Raja SG, Garg S, Rochon M, et al. Short-term clinical outcomes and long-term survival of minimally invasive direct coronary artery bypass grafting. Ann Cardiothorac Surg, 2018, 7(5): 621-627.
3. Doenst T, Haverich A, Serruys P, et al. PCI and CABG for treating stable coronary artery disease: JACC review topic of the week. J Am Coll Cardiol, 2019, 73(8): 964-976.
4. Nyström T, Sartipy U, Franzén S, et al. PCI versus CABG in patients with type 1 diabetes and multivessel disease. J Am Coll Cardiol, 2017, 70(12): 1441-1451.
5. Diab M, Färber G, Sponholz C, et al. Coronary artery bypass grafting using bilateral internal thoracic arteries through a left-sided minithoracotomy: A single-center starting experience. Thorac Cardiovasc Surg, 2019, 67(6): 437-443.
6. Sixt S, Aubin H, Kalb R, et al. Continuous procedural full-lung ventilation during minimally invasive coronary bypass grafting. Ann Thorac Surg, 2017, 104(6): 1994-2000.
7. McGinn JT, Usman S, Lapierre H, et al. Minimally invasive coronary artery bypass grafting: dual-center experience in 450 consecutive patients. Circulation, 2009, 120(11 Suppl): S78-S84.
8. Ruel M, Shariff MA, Lapierre H, et al. Results of the minimally invasive coronary artery bypass grafting angiographic patency study. J Thorac Cardiovasc Surg, 2014, 147(1): 203-208.
9. Lemma M, Atanasiou T, Contino M. Minimally invasive cardiac surgery-coronary artery bypass graft. Multimed Man Cardiothorac Surg, 2013, 2013: mmt007.
10. Kikuchi K, Une D, Kurata A, et al. Off-pump minimally invasive coronary artery bypass grafting using the bilateral internal thoracic arteries and the right gastroepiproic artery. Eur J Cardiothorac Surg, 2016, 49(4): 1285-1286.
11. Lapierre H, Chan V, Sohmer B, et al. Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study. Eur J Cardiothorac Surg, 2011, 40(4): 804-810.
12. Kikuchi K, Une D, Suzuki K, et al. Off-pump minimally invasive coronary artery bypass grafting with a heart positioner: Direct retraction for a better exposure. Innovations (Phila), 2015, 10(3): 183-187.
13. Barsoum EA, Azab B, Shah N, et al. Long-term mortality in minimally invasive compared with sternotomy coronary artery bypass surgery in the geriatric population (75 years and older patients). Eur J Cardiothorac Surg, 2015, 47(5): 862-867.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

On-pump coronary artery bypass grafting for the treatment of multivessel diseases via left anterolateral minithoracotomy

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