Key result
Off-pump total arterial MICS CABG with BITA and right gastroepiploic artery achieves complete graft patency.
Case Report (n=1)
No
Off-pump MICS CABG with total arterial grafts using BITA and the right gastroepiploic artery is feasible and can be safely performed, offering potential long-term benefits of arterial grafts.
We report our initial experience of an off-pump total arterial minimally invasive coronary arterial bypass grafting (MICS CABG) with the use of bilateral internal thoracic arteries (BITA) and the right gastroepiproic artery. A 47-year old male with renal dysfunction secondary to diabetes mellitus was admitted for heart failure due to severe triple-vessel disease. Off-pump MICS CABG with total arterial grafts was elected because the patient refused to undergo median sternotomy due to the strong desire to regain the baseline function promptly. Total arterial grafts were selected to maximize the potential long-term outcome. There were no postoperative complications except temporary dialysis. Postoperative coronary computed tomography revealed the patency of all grafts. Our experience suggests that BITA can be safely harvested under direct vision in MICS CABG. Total arterial graft revascularization with BITA via minimally invasive approach may offer the benefits of MICS CABG while providing the undetermined but potentially superior conduit longevity of arterial grafts.
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Kikuchi et al. (2015) conducted a case report in Severe triple-vessel disease and heart failure (n=1). Off-pump total arterial minimally invasive coronary arterial bypass grafting (MICS CABG) with bilateral internal thoracic arteries and right gastroepiploic artery was evaluated on Postoperative complications and graft patency. Off-pump total arterial MICS CABG using bilateral internal thoracic arteries and the right gastroepiploic artery was successfully performed with all grafts patent postoperatively.
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