Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

다국어 초록 (Multilingual 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±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.

참고문헌 (Reference)

1 Regragui I, "The effects of cardiopulmonary bypass temperature on neuropsychologic outcome after coronary artery operations: a prospective randomized trial" 112 : 1036-1045, 1996

2 Tatoulis J, "Patencies of 2127 arterial to coronary conduits over 15 years" 77 : 93-101, 2004

3 Widimsky P, "One-year coronary bypass graft patency: a randomized comparison between off-pump and on-pump surgery angiographic results of the PRAGUE-4 trial" 110 : 3418-3423, 2004

4 Kettering K, "Minimally invasive direct coronary artery bypass grafting: a meta-analysis" 49 : 793-800, 2008

5 Bonchek LI, "Minimally invasive coronary bypass:a dissenting opinion" 98 : 495-497, 1998

6 Borst C, "Minimally invasive coronary artery bypass grafting: an experimental perspective" 99 : 1400-1403, 1999

7 Calafiore AM, "Midterm results after minimally invasive coronary surgery (LAST operation)" 115 : 763-771, 1998

8 Kim KB, "Midterm angiographic follow-up after off-pump coronary artery bypass: serial comparison using early, 1-year, and 5-year postoperative angiograms" 135 : 300-307, 2008

9 Angelini GD, "Integrated left small thoracotomy and angioplasty for multivessel coronary artery revascularisation" 347 : 757-758, 1996

10 Popma JJ, "Hybrid myocardial revascularization: an integrated approach to coronary revascularization" 75 (75): S28-S34, 2010

11 Narasimhan S, "Hybrid coronary revascularization: a review" 19 : 101-107, 2011

12 Friedrich GJ, "Hybrid coronary artery revascularization:review and update 2007" 10 : E292-E296, 2007

13 Alexander JH, "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" 294 : 2446-2454, 2005

14 DeRose JJ, "Current state of integrated “hybrid” coronary revascularization" 21 : 229-236, 2009

15 Cameron A, "Coronary bypass surgery with internal-thoracic-artery grafts: effects on survival over a 15-year period" 334 : 216-219, 1996

16 Magee MJ, "Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV" 85 : 494-499, 2008

17 Hayward PA, "Contemporary coronary graft patency:5-year observational data from a randomized trial of conduits" 84 : 795-799, 2007

18 Kirklin JK, "Complement and the damaging effects of cardiopulmonary bypass" 86 : 845-857, 1983

19 Salasidis GC, "Carotid artery duplex scanning in preoperative assessment for coronary artery revascularization: the association between peripheral vascular disease, carotid artery stenosis, and stroke" 21 : 154-160, 1995

20 Hillis LD, "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" 58 : e123-e210, 2011