Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

  • Kang, Joonkyu (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Song, Hyun (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Seok In (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Moon, Mi Hyung (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Hwan Wook (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jo, Gyun Hyun (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • Received : 2013.08.23
  • Accepted : 2013.10.15
  • Published : 2014.04.05
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Abstract

Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

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References

  1. DeRose JJ. Current state of integrated "hybrid" coronary revascularization. Semin Thorac Cardiovasc Surg 2009;21: 229-36. https://doi.org/10.1053/j.semtcvs.2009.08.004
  2. Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg 2004; 77:93-101. https://doi.org/10.1016/S0003-4975(03)01331-6
  3. Narasimhan S, Srinivas VS, DeRose JJ Jr. Hybrid coronary revascularization: a review. Cardiol Rev 2011;19:101-7. https://doi.org/10.1097/CRD.0b013e3182140330
  4. Angelini GD, Wilde P, Salerno TA, Bosco G, Calafiore AM. Integrated left small thoracotomy and angioplasty for multivessel coronary artery revascularisation. Lancet 1996;347:757-8.
  5. Friedrich GJ, Bonatti J. Hybrid coronary artery revascularization: review and update 2007. Heart Surg Forum 2007;10:E292-6. https://doi.org/10.1532/HSF98.20070708
  6. Popma JJ, Nathan S, Hagberg RC, Khabbaz KR. Hybrid myocardial revascularization: an integrated approach to coronary revascularization. Catheter Cardiovasc Interv 2010;75 Suppl 1:S28-34. https://doi.org/10.1002/ccd.22402
  7. Bonchek LI, Ullyot DJ. Minimally invasive coronary bypass: a dissenting opinion. Circulation 1998;98:495-7. https://doi.org/10.1161/01.CIR.98.6.495
  8. Calafiore AM, Di Giammarco G, Teodori G, et al. Midterm results after minimally invasive coronary surgery (LAST operation). J Thorac Cardiovasc Surg 1998;115:763-71. https://doi.org/10.1016/S0022-5223(98)70353-8
  9. Kettering K. Minimally invasive direct coronary artery bypass grafting: a meta-analysis. J Cardiovasc Surg (Torino) 2008;49:793-800.
  10. Cameron A, Davis KB, Green G, Schaff HV. Coronary bypass surgery with internal-thoracic-artery grafts: effects on survival over a 15-year period. N Engl J Med 1996;334:216-9. https://doi.org/10.1056/NEJM199601253340402
  11. Kirklin JK, Westaby S, Blackstone EH, Kirklin JW, Chenoweth DE, Pacifico AD. Complement and the damaging effects of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983;86:845-57.
  12. Salasidis GC, Latter DA, Steinmetz OK, Blair JF, Graham AM. Carotid artery duplex scanning in preoperative assessment for coronary artery revascularization: the association between peripheral vascular disease, carotid artery stenosis, and stroke. J Vasc Surg 1995;21:154-60. https://doi.org/10.1016/S0741-5214(95)70254-7
  13. Regragui I, Birdi I, Izzat MB, et al. The effects of cardiopulmonary bypass temperature on neuropsychologic outcome after coronary artery operations: a prospective randomized trial. J Thorac Cardiovasc Surg 1996;112:1036-45. https://doi.org/10.1016/S0022-5223(96)70105-8
  14. Kim KB, Cho KR, Jeong DS. Midterm angiographic follow- up after off-pump coronary artery bypass: serial comparison using early, 1-year, and 5-year postoperative angiograms. J Thorac Cardiovasc Surg 2008;135:300-7. https://doi.org/10.1016/j.jtcvs.2007.09.044
  15. Hayward PA, Buxton BF. Contemporary coronary graft patency: 5-year observational data from a randomized trial of conduits. Ann Thorac Surg 2007;84:795-9. https://doi.org/10.1016/j.athoracsur.2007.04.028
  16. Alexander JH, Hafley G, Harrington RA, et al. Efficacy and safety of edifoligide, an E2F transcription factor decoy, for prevention of vein graft failure following coronary artery bypass graft surgery: PREVENT IV: a randomized controlled trial. JAMA 2005;294:2446-54. https://doi.org/10.1001/jama.294.19.2446
  17. Magee MJ, Alexander JH, Hafley G, et al. Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV. Ann Thorac Surg 2008;85:494-9. https://doi.org/10.1016/j.athoracsur.2007.10.008
  18. Widimsky P, Straka Z, Stros P, et al. One-year coronary bypass graft patency: a randomized comparison between off-pump and on-pump surgery angiographic results of the PRAGUE-4 trial. Circulation 2004;110:3418-23. https://doi.org/10.1161/01.CIR.0000148139.79580.36
  19. Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol 2011;58:e123-210. https://doi.org/10.1016/j.jacc.2011.08.009
  20. Borst C, Grundeman PF. Minimally invasive coronary artery bypass grafting: an experimental perspective. Circulation 1999;99:1400-3. https://doi.org/10.1161/01.CIR.99.11.1400

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