scholarly journals Microscope-assisted coronary artery bypass grafting: features of creating side-to-side anastomosis

2021 ◽  
Vol 25 (2) ◽  
pp. 102
Author(s):  
A. N. Semchenko ◽  
A. D. Makarov
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Conflict Of Interest ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Operating Microscope ◽  
Artery Bypass Grafting ◽  
Coronary Bypass Grafting

<p>This paper describes the step-by-step technique of microscope-assisted creation of side-to-side anastomosis for sequential coronary bypass grafting and the simplified mastering of microscope-assisted coronary artery bypass grafting. Based on our experience, we describe the optimal magnification of the operating microscope, the preferred dimensions of the suture material and the types of microsurgical instruments. We describe in detail the technique and features of microscope-assisted creation of side-to-side anastomosis. In conclusion, we provide brief information about the global practice of microscope-assisted coronary bypass grafting and discuss the advantages of using an operating microscope and microsurgical technologies for creating side-to-side coronary anastomoses.</p><p>Received 12 October 2020. Revised 14 November 2020. Accepted 17 November 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Chylothorax as a complication of coronary artery bypass grafting operation

2012 ◽  
Vol 153 (14) ◽  
pp. 553-558 ◽  
Author(s):  
Miklós Szabó ◽  
Margit †Jáger ◽  
Eszter Krizsó ◽  
Ibolya Gilányi ◽  
Andrij Leny ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Surgical Interventions ◽  
Artery Bypass Grafting ◽  
Coronary Bypass Grafting ◽  
Triglyceride Content

The authors present the case of a 72-year-old woman who underwent coronary bypass grafting. Left sided chylothorax due to accidental dissection of a thoracic duct branch developed 2 months after sternotomy. As conservative therapy has failed, surgical pleurodesis was performed successfully. Chylothorax is a rare and underestimated complication of coronary bypass grafting. The worldwide increasing number of coronary artery bypass grafting surgeries makes it important to pay attention to this condition. Thus diagnosis of the chyle is relatively easy by its high chylomicron and triglyceride content, but identification of the etiology and its treatment is sometimes challenging for the physician. The treatment of chylothorax is usually conservative. The main goal is to keep the volume of the chyle under control. The number of surgical interventions because of chylothorax is increasing due to an increase of iatrogenic etiology. Orv. Hetil., 2012, 153, 553–558.

scholarly journals An original method of pericardium closure after coronary artery bypass grafting

2021 ◽  
Vol 25 (2) ◽  
pp. 95
Author(s):  
G. G. Kvaratskheliya ◽  
E. P. Golubev ◽  
U. S. Avkhadov ◽  
R. M. Ibragimov ◽  
B. E. Rustamov ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Conflict Of Interest ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Bypass Grafts ◽  
Artery Bypass Grafting ◽  
Coronary Bypass Grafts

<p>Different cardiac surgery centres have different views regarding pericardial suturing. However, there is limited scientific evidence confirming the advantage of one method over another, which disallows us from forming a general opinion regarding specialists. Here, we describe several well-known methods of suturing the pericardium and preventing traumatisation of coronary bypass grafts and analyse their weaknesses. An original technique of opening and suturing the pericardium is proposed to restore the physiological distinction between the pericardial cavity and the anterior mediastinum during coronary artery bypass grafting without the risk of compromising the functioning coronary bypass grafts and narrow mediastinal syndrome.<br />The proposed method of suturing the pericardium received a patent for invention, No. 2733505, dated 2 October, 2020. In the A.N. Bakulev National Medical Research Center for Cardiovascular Surgery (Moscow, Russian Federation), this technique of suturing the pericardium has been routinely used since 2006. More than 2,000 intraoperative shunt scans have been performed in our department since 2009; all these scans were performed after the pericardium was closed, proving that the fear of compromising the shunts during pericardial suturing is unsupported.</p><p>Received 17 December 2020. Revised 13 January 2021. Accepted 18 January 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: G.G. Kvaratskheliya, E.P. Golubev<br />Data collection and analysis: U.S. Avkhadov, R.M. Ibragimov<br />Drafting the article: G.G. Kvaratskheliya, E.P. Golubev<br />Critical revision of the article: E.U. Asymbekova, B.E. Rustamov, L.S. Shakhnazaryan, Yu.I. Buziashvili<br />Final approval of the version to be published: G.G. Kvaratskheliya, E.P. Golubev, U.S. Avkhadov, R.M. Ibragimov, B.E. Rustamov, E.U. Asymbekova, L.S. Shakhnazaryan, Yu.I. Buziashvili</p><p> </p>

scholarly journals Coronary Bypass Surgery in a 105-Year-Old Patient with Cardiopulmonary Bypass

2010 ◽  
Vol 2010 ◽  
pp. 1-3
Author(s):  
Temucin Noyan Ogus ◽  
Filiz Erdim ◽  
Ozer Selimoglu ◽  
Fatih Tekiner ◽  
Murat Ugurlucan
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Management Strategy ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Coronary artery bypass grafting is one of the routine daily surgical procedures in the current era. Parallel to the increasing life expectancy, cardiac surgery is commonly performed in octogenarians. However, literature consists of only seldom reports of coronary artery bypass grafting in patients above 90 years of age. In this report, we present our management strategy in a 105-year-old patient who underwent coronary artery bypass grafting at our institution.

Combined Totally Endoscopic Robotic Coronary Bypass and Mitral Valve Repair via Right-Sided Ports

2013 ◽  
Vol 8 (4) ◽  
pp. 310-315 ◽  
Author(s):  
Kimberly A. Maciolek ◽  
Dorothy J. Krienbring ◽  
Efstathios S. Naum ◽  
Susan E. Arnsdorf ◽  
Husam H. Balkhy
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Mitral Valve ◽  
Coronary Artery Bypass ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Left Anterior Descending Artery

We present a case of combined coronary artery bypass grafting and mitral valve (MV) repair using a robotic totally endoscopic right-sided approach. A 61-year-old man presented with fatigue due to significant mitral regurgitation and was found to have a tight stenosis in the mid left anterior descending artery. Using the da Vinci robotic system, the patient underwent a left internal mammary artery graft to the left anterior descending artery using the C-Port Flex A distal anastomotic device followed by a MV repair. Both procedures were performed endoscopically via right chest ports and right femorofemoral bypass successfully. The patient was discharged from the hospital 3 days postoperatively and returned to normal activity within 3 weeks after surgery. This case study shows the feasibility of using an endoscopic robotic approach in selected patients undergoing combined MV coronary artery bypass grafting surgery.

scholarly journals Arterial Grafts for Coronary Bypass

Circulation ◽  
2019 ◽  
Vol 140 (15) ◽  
pp. 1273-1284 ◽  
Author(s):  
Mario Gaudino ◽  
Faisal G. Bakaeen ◽  
Umberto Benedetto ◽  
Antonino Di Franco ◽  
Stephen Fremes ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Randomized Trial ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Pooled Analysis ◽  
Bypass Grafting ◽  
Arterial Grafts ◽  
Artery Bypass Grafting

Observational and randomized evidence shows that arterial grafts have better patency rates than saphenous vein grafts (SVGs) in coronary artery bypass grafting. Observational studies suggest that the use of multiple arterial grafts is associated with longer postoperative survival, but this must be interpreted in the context of treatment allocation bias and hidden confounders intrinsic to the study designs. Recently, a pooled analysis of 6 randomized trials comparing the radial artery with the SVG as the second conduit and the largest randomized trial comparing the use of single and bilateral internal thoracic arteries have provided apparently divergent results about a clinical benefit with the use of >1 arterial conduit. However, both analyses have methodological limitations that may have influenced their results. At present, it is unclear whether the well-documented increased patency rate of arterial grafts translates into clinical benefits in the majority of patients undergoing coronary artery bypass grafting. A large randomized trial testing the arterial grafts hypothesis (ROMA [Randomized Comparison of the Clinical Outcome of Single Versus Multiple Arterial Grafts]) is underway and will report the results in a few years.

Predictors and Outcomes of Sternotomy Conversion and Cardiopulmonary Bypass Assistance in Minimally Invasive Coronary Artery Bypass Grafting

2016 ◽  
Vol 11 (5) ◽  
pp. 315-320 ◽  
Author(s):  
Maria L. Rodriguez ◽  
Harry R. Lapierre ◽  
Benjamin Sohmer ◽  
Jean-Philippe Ruel ◽  
Marc A. Ruel
Keyword(s):  
Risk Factors ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Objective This work's objective was to identify the determinants of conversion of minimally invasive coronary artery bypass grafting to sternotomy, with and without cardiopulmonary bypass assistance, and to compare clinical outcomes in patients who needed conversion. Methods This is a prospectively collected data on patients who underwent minimally invasive coronary bypass done by a single surgeon from February 2005 to September 2014. Statistical analyses were expressed as mean values ± standard deviation or proportions. Results The total number of patients was 266, with an average age of 62 years. The median number of grafted territories was 2, higher in those with pump assistance (median, 3 grafts; P ≤ 0.01). Predictors for use of cardiopulmonary bypass included diabetes, 3-vessel disease, left circumflex involvement, and small target vessels (P < 0.05). The rate for sternotomy conversion was 3.8%. Risk factors for conversion to sternotomy included smoking, preoperative bradycardia (<50 beats per minute), low intraoperative ejection fraction, inability to tolerate one-lung ventilation, inadequate surgical exposure, and hemodynamic instability. Postoperative complications included superficial thoracotomy infection (3%), sternotomy infection (10%), new atrial fibrillation (3%), and need for blood transfusion (14%). Twelve patients (5%) developed left-sided pleural effusion that required drainage. There were no perioperative deaths, major adverse cardiac event, or stroke. Conclusions Minimally invasive coronary bypass grafting with conversion to sternotomy and use of cardiopulmonary bypass is safe. Conversions may be alleviated by an effort to optimize modifiable risk factors and the adequacy of surgical exposure. These data may help develop objective selection criteria to identify patients who are excellent candidates for the procedure.

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