Reducing cardiac surgical trauma: the minimally invasive direct coronary artery bypass

Autor:	J R Handy, J L Zellner, Richard L. Fishman, Susan C. Harvey, M L Pinosky
Rok vydání:	1997
Předmět:	medicine.medical_specialty Sternum medicine.medical_treatment Revascularization law.invention Coronary artery disease law Cardiopulmonary bypass medicine Thoracoscopy Humans Minimally Invasive Surgical Procedures Anesthesia Thoracotomy Coronary Artery Bypass medicine.diagnostic_test business.industry Patient Selection Endoscopy General Medicine medicine.disease Cardiac surgery Surgery Transplantation surgical procedures operative Median sternotomy business
Zdroj:	Southern medical journal. 90(10)
ISSN:	0038-4348
Popis:	Background The concept of minimal surgical trauma is revolutionizing many surgical subspecialties, including cardiac surgery. Coronary artery revascularization can now be accomplished either thoracoscopically or through a small thoracotomy, sternotomy, or epigastric incision, with or without cardiopulmonary bypass (CPB). Methods The current literature was reviewed with regard to patient selection criteria for coronary artery bypass grafting (CABG) without CPB, indications for minimally invasive direct coronary artery bypass (MIDCAB), surgical and anesthetic technique, and outcome. Results The MIDCAB is largely used in cases of single or double vessel disease. The procedure is done either thoracoscopically or under direct vision through a small incision rather than standard sternotomy. In non-CPB cases, the heart is pharmacologically manipulated to create a quiet operative field. Patients may be extubated and become ambulatory shortly after surgery and be discharged within a few days. Conclusions The MIDCAB avoids median sternotomy and, in many cases, CPB. MIDCAB may prove to play a prominent role in management of coronary artery disease in the future.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::15907d7a65896bdc97e9a205dacb77cf https://pubmed.ncbi.nlm.nih.gov/9347805 Zobrazit plný text záznamu Plný text ve formátu HTML
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