Thoracoscopic mammary artery mobilization in redo minimally invasive coronary bypass operations

作     者：Wolf, RK Miyaji, K Flege, JB 

作者机构：Christ Hosp Dept Cardiac Surg Cincinnati OH 45219 USA Jewish Hosp Cincinnati Div Cardiac Surg Cincinnati OH USA 

出 版 物：《ANNALS OF THORACIC SURGERY》 (胸外科学纪事)

年 卷 期：1999年第68卷第4期

页      面：1540-1541页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：冠状动脉分流术/仪器和设备 内窥镜检查 移植物闭塞 血管 心肌血管重建术/仪器和设备 再手术 外科器械 胸腔镜 老年人 老年人 80以上 女(雌)性 人类 男(雄)性 中年人 

摘      要：Background. It has been stated that thoracoscopic internal thoracic artery (ITA) mobilization is not recommended in the redo minimally invasive direct coronary artery bypass (FI MIDCAB) situation, presumably because adhesions from the previous coronary artery bypass grafting operation may preclude a thoracoscopic approach. However, there are advantages to thoracoscopic ITA mobilization in MIDCAB that could also be realized in the redo situation. Methods. In 200 MIDCAB procedures over the last 3 and a half years, 11 patients, ages 49-83 (mean 69), were identified as having undergone an attempted ITA mobilization in a redo situation. Results. Thoracoscopic ITA mobilization was successful in 9 out of 11 patients (81%). One patient had complete pleural symphysis precluding this approach, and 1 patient had poor mammary now after harvest and this conduit was not used. Both failures were in female octogenarians. Conclusions. To realize the advantages of a tharacoscopic ITA mobilization MIDCAB, both right and left thoracoscopic ITA mobiIization can safely be performed in the redo situation. Thoracic adhesions precluding a thoracoscopic approach were encountered in only 1 of 11 redo coronary artery bypass grafting patients. (C) 1999 by The Society of Thoracic Surgeons.