European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Oct 1998
Video-assisted minimally invasive coronary bypass surgery without cardiopulmonary bypass.
There is a growing interest in cardiac surgery towards minimally invasive approach to coronary bypass operations without cardiopulmonary bypass. ⋯ MIDCABG is, in selected patients, reliable and safe, and offers encouraging early and mid-term clinical results.
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Eur J Cardiothorac Surg · Oct 1998
Minimally invasive aortic valve replacement without sternotomy. Experience with the first 50 cases.
The method of replacing the aortic valve via a mini-thoracotomy has been reported in the recent literature. Although this strategy has clear advantages, further refinements of the process make the procedure even less invasive. ⋯ The advantages of the present method include further reduction of hospital trauma, preservation of chest wall integrity, early mobilization and rehabilitation of the patient. Surgical technical improvements include avoidance of groin cannulation, simpler equipment, and an easy access in case of reoperation.
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Eur J Cardiothorac Surg · Oct 1998
Coronary artery bypass grafting without cardiopulmonary bypass--initial experience of 50 cases.
This study was undertaken to assess our experience with the first 50 patients who underwent CABG without cardiopulmonary bypass. In seven patients left internal mammary artery to left anterior descending artery (LIMA-LAD) grafting was performed through a short left anterior thoracotomy. In 43 other patients median sternotomy was used. ⋯ His left internal mammary artery (LIMA) graft was occluded; we replaced it with a vein graft. All 47 survivors remain asymptomatic, with the mean follow-up time of 6 months. Coronary surgery without cardiopulmonary bypass seems a valuable alternative for high-risk patients.
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Eur J Cardiothorac Surg · Oct 1998
Less-invasive coronary artery bypass grafting: different techniques and approaches.
The aim of this study was to compare four different techniques for less-invasive coronary artery bypass surgery with and without cardiopulmonary bypass (CPB) in terms of feasibility as well as in terms of the intra- and postoperative course. ⋯ Based on our results, the following strategy has been developed: MIDCAB without CPB is the preferred technique for one-vessel graft procedures to the left anterior descendens (LAD) or RCA. The Port Access system (with CPB) is reserved as a second option for young patients requiring multiple-vessel grafting to the left coronary circulation (LAD/CX) and as a backup to avoid conversion. Sternotomy and an off-pump technique is used for single-vessel or multiple-vessel graft procedures in selected patients (emergency procedure, acute myocardial infarction, in the very obese).
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Eur J Cardiothorac Surg · Oct 1998
Single coronary artery bypass grafting--a comparison between minimally invasive 'off pump' techniques and conventional procedures.
At present, few studies directly comparing minimally invasive and conventional coronary artery bypass grafting are available. The aim of the present study was to evaluate the clinical outcome of the two techniques. ⋯ We conclude that minimally invasive coronary artery bypass grafting on the beating heart in comparison to conventional single coronary artery bypass grafting during the learning curve requires longer operative times but can reduce blood transfusion requirements and hospital stay.