Needle-guided mini-entry in video-assisted coronary artery bypass
- 作者：Ohtsuka ; Toshiya ; Ninomiya ; Mikio ; Maemura ; Taisei ; Takamoto ; Shinichi
- 关键词：Minimally invasive coronary artery surgery ; Mini-thoracotomy ; Access-port ; Video-assisted needle-guided technique
- 刊名：European Journal of Cardio-Thoracic Surgery
- 出版年：2003
- 期刊代码：89_10107940
- 类别：med
- 出版时间：October, 2003
- 卷：24
- 期：4
- 页码：644-646
- 文件大小：122 K
摘要
In minimally invasive coronary artery bypass (MICAB), a video-assisted needle-guided technique was used to make a mini-thoracotomy or an access-port just above the target site in the left anterior descending coronary artery (LAD). After thoracoscopic preparation of the left internal thoracic artery (LITA) and pericardiotomy, a 7-cm, 23-gauge needle was used to examine the skin-point where the needle vertically penetrated the chest wall and thoracoscopically indicated the target site in the LAD. This point was used as the mid-point of the skin incision for a 6-cm thoracotomy (six cases) or a 33-mm access-port (four cases). Consequently, there was no conversion of approach except in the patient with pulmonary dysfunction, and each LITA–LAD anastomosis was completed directly through the mini-entry. There was no mortality and no procedure-related morbidity. Patency of each graft was confirmed within a week after surgery. After a mean follow-up period of 12.5±7.8 months, all of the patients except one, who died of stroke 1 year after surgery, are alive with no ischemic events. Although our experience is limited, the present video-assisted needle-guided technique can be a simple method to facilitate appropriate positioning of a mini-entry in MICAB to the LAD with a thoracoscopically prepared LITA graft.