Minimally invasive direct coronary artery bypass (MIDCAB) surgery: Technical aspects

Fu-Chean Chen, C. L. Lin, S. F. Chao, C. P. Lai, J. H. Wang, W. P. Tseng

Research output: Contribution to journalArticle

Abstract

Minimally invasive direct coronary artery bypass surgery without cardiopulmonary bypass is gaining popularity for the surgical revascularization of patients with selected coronary artery disease. The most frequent procedure is left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery bypass graft using left anterior small thoracotomy (LAST) incision. The LIMA can be dissected under direct vision or through video-assisted device. Recently, we used minimally invasive direct coronary artery bypass (MIDCAB) surgery on the beating heart without cardiopulmonary bypass for single- or double- vessel coronary artery disease patients. Twelve patients with symptomatic coronary artery disease were included in this study. These patients underwent attempted MIDCAB surgery. A LAST incision, about 8 cm long, was made in the fourth intercostal space and the fourth intercostal cartilage was excised (third cartilage also, if needed). The LIMA was mobilized for about 6 cm under direct vision. End to side, LIMA to LAD coronary artery anastomosis was performed for nine patients with single vessel LAD disease and median sternotomy with a vein graft was performed for one patient with double-vessed disease. These ten patients all underwent MIDCAB on beating hearts without cardiopulmonary bypass. Of the twelve study patients, two required converion to traditional approach median sterotomy with cardiopulmonary bypass, one patient for intramyocardial and the other because of calcified LAD. In conclusion, MIDCAB surgery can be performed with success under careful patient selection.

Original languageEnglish
Pages (from-to)279-284
Number of pages6
JournalTzu Chi Medical Journal
Volume10
Issue number4
Publication statusPublished - 1998

Fingerprint

Coronary Artery Bypass
Mammary Arteries
Cardiopulmonary Bypass
Coronary Artery Disease
Thoracotomy
Cartilage
Off-Pump Coronary Artery Bypass
Transplants
Sternotomy
Patient Selection
Veins
Coronary Vessels
Equipment and Supplies

Keywords

  • Cardiopulmonary bypass
  • Coronary artery bypass graft
  • Internal mammary artery
  • Left anterior small thoracotomy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Chen, F-C., Lin, C. L., Chao, S. F., Lai, C. P., Wang, J. H., & Tseng, W. P. (1998). Minimally invasive direct coronary artery bypass (MIDCAB) surgery: Technical aspects. Tzu Chi Medical Journal, 10(4), 279-284.

Minimally invasive direct coronary artery bypass (MIDCAB) surgery : Technical aspects. / Chen, Fu-Chean; Lin, C. L.; Chao, S. F.; Lai, C. P.; Wang, J. H.; Tseng, W. P.

In: Tzu Chi Medical Journal, Vol. 10, No. 4, 1998, p. 279-284.

Research output: Contribution to journalArticle

Chen, F-C, Lin, CL, Chao, SF, Lai, CP, Wang, JH & Tseng, WP 1998, 'Minimally invasive direct coronary artery bypass (MIDCAB) surgery: Technical aspects', Tzu Chi Medical Journal, vol. 10, no. 4, pp. 279-284.
Chen F-C, Lin CL, Chao SF, Lai CP, Wang JH, Tseng WP. Minimally invasive direct coronary artery bypass (MIDCAB) surgery: Technical aspects. Tzu Chi Medical Journal. 1998;10(4):279-284.
Chen, Fu-Chean ; Lin, C. L. ; Chao, S. F. ; Lai, C. P. ; Wang, J. H. ; Tseng, W. P. / Minimally invasive direct coronary artery bypass (MIDCAB) surgery : Technical aspects. In: Tzu Chi Medical Journal. 1998 ; Vol. 10, No. 4. pp. 279-284.
@article{94813fbc266a47c4b4a2d875e4fd7f06,
title = "Minimally invasive direct coronary artery bypass (MIDCAB) surgery: Technical aspects",
abstract = "Minimally invasive direct coronary artery bypass surgery without cardiopulmonary bypass is gaining popularity for the surgical revascularization of patients with selected coronary artery disease. The most frequent procedure is left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery bypass graft using left anterior small thoracotomy (LAST) incision. The LIMA can be dissected under direct vision or through video-assisted device. Recently, we used minimally invasive direct coronary artery bypass (MIDCAB) surgery on the beating heart without cardiopulmonary bypass for single- or double- vessel coronary artery disease patients. Twelve patients with symptomatic coronary artery disease were included in this study. These patients underwent attempted MIDCAB surgery. A LAST incision, about 8 cm long, was made in the fourth intercostal space and the fourth intercostal cartilage was excised (third cartilage also, if needed). The LIMA was mobilized for about 6 cm under direct vision. End to side, LIMA to LAD coronary artery anastomosis was performed for nine patients with single vessel LAD disease and median sternotomy with a vein graft was performed for one patient with double-vessed disease. These ten patients all underwent MIDCAB on beating hearts without cardiopulmonary bypass. Of the twelve study patients, two required converion to traditional approach median sterotomy with cardiopulmonary bypass, one patient for intramyocardial and the other because of calcified LAD. In conclusion, MIDCAB surgery can be performed with success under careful patient selection.",
keywords = "Cardiopulmonary bypass, Coronary artery bypass graft, Internal mammary artery, Left anterior small thoracotomy",
author = "Fu-Chean Chen and Lin, {C. L.} and Chao, {S. F.} and Lai, {C. P.} and Wang, {J. H.} and Tseng, {W. P.}",
year = "1998",
language = "English",
volume = "10",
pages = "279--284",
journal = "Tzu Chi Medical Journal",
issn = "1016-3190",
publisher = "財團法人中華民國佛教慈濟慈善事業基金會",
number = "4",

}

TY - JOUR

T1 - Minimally invasive direct coronary artery bypass (MIDCAB) surgery

T2 - Technical aspects

AU - Chen, Fu-Chean

AU - Lin, C. L.

AU - Chao, S. F.

AU - Lai, C. P.

AU - Wang, J. H.

AU - Tseng, W. P.

PY - 1998

Y1 - 1998

N2 - Minimally invasive direct coronary artery bypass surgery without cardiopulmonary bypass is gaining popularity for the surgical revascularization of patients with selected coronary artery disease. The most frequent procedure is left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery bypass graft using left anterior small thoracotomy (LAST) incision. The LIMA can be dissected under direct vision or through video-assisted device. Recently, we used minimally invasive direct coronary artery bypass (MIDCAB) surgery on the beating heart without cardiopulmonary bypass for single- or double- vessel coronary artery disease patients. Twelve patients with symptomatic coronary artery disease were included in this study. These patients underwent attempted MIDCAB surgery. A LAST incision, about 8 cm long, was made in the fourth intercostal space and the fourth intercostal cartilage was excised (third cartilage also, if needed). The LIMA was mobilized for about 6 cm under direct vision. End to side, LIMA to LAD coronary artery anastomosis was performed for nine patients with single vessel LAD disease and median sternotomy with a vein graft was performed for one patient with double-vessed disease. These ten patients all underwent MIDCAB on beating hearts without cardiopulmonary bypass. Of the twelve study patients, two required converion to traditional approach median sterotomy with cardiopulmonary bypass, one patient for intramyocardial and the other because of calcified LAD. In conclusion, MIDCAB surgery can be performed with success under careful patient selection.

AB - Minimally invasive direct coronary artery bypass surgery without cardiopulmonary bypass is gaining popularity for the surgical revascularization of patients with selected coronary artery disease. The most frequent procedure is left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery bypass graft using left anterior small thoracotomy (LAST) incision. The LIMA can be dissected under direct vision or through video-assisted device. Recently, we used minimally invasive direct coronary artery bypass (MIDCAB) surgery on the beating heart without cardiopulmonary bypass for single- or double- vessel coronary artery disease patients. Twelve patients with symptomatic coronary artery disease were included in this study. These patients underwent attempted MIDCAB surgery. A LAST incision, about 8 cm long, was made in the fourth intercostal space and the fourth intercostal cartilage was excised (third cartilage also, if needed). The LIMA was mobilized for about 6 cm under direct vision. End to side, LIMA to LAD coronary artery anastomosis was performed for nine patients with single vessel LAD disease and median sternotomy with a vein graft was performed for one patient with double-vessed disease. These ten patients all underwent MIDCAB on beating hearts without cardiopulmonary bypass. Of the twelve study patients, two required converion to traditional approach median sterotomy with cardiopulmonary bypass, one patient for intramyocardial and the other because of calcified LAD. In conclusion, MIDCAB surgery can be performed with success under careful patient selection.

KW - Cardiopulmonary bypass

KW - Coronary artery bypass graft

KW - Internal mammary artery

KW - Left anterior small thoracotomy

UR - http://www.scopus.com/inward/record.url?scp=0032406312&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032406312&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0032406312

VL - 10

SP - 279

EP - 284

JO - Tzu Chi Medical Journal

JF - Tzu Chi Medical Journal

SN - 1016-3190

IS - 4

ER -