Multiple Coronary Artery Bypass Via Mini Left Thoracotomy With Conventional Aortic Occlusion

(#2000-2588... November 6, 2000)

Alex Zapolanski, MD, Keith Korver, MD, Michael B. Pliam, MD, PhD, Laurel Mengarelli, CRNFA, Richard Shaw, PhD

San Francisco Heart Institute, Daly City, California

ABSTRACT

Background: Complete myocardial revascularization can be achieved through a mini left anterior thoracotomy. Our approach (West Coast Technique) takes advantage of the Port-Access™ (Heartport®, Redwood City, CA) concept while utilizing conventional instrumentation.

Methods: Thirty-eight patients underwent multiple coronary artery bypass grafting (CABG). Aortic occlusion was performed using a transthoracic clamp, and all anastomoses were performed under a single cross-clamp.

Results: There were no deaths and no neurologic deficits. There was one perioperative myocardial infarction (MI), and one re-exploration for bleeding. Ten patients (26%) required blood transfusions, and five patients (13%) developed atrial fibrillation. The average number of grafts per patient was 2.9, and average hospital stay was 5.2 days.

Conclusion: Multiple CABG can be accomplished safely through a minithoracotomy, which eliminates the need for endoaortic occlusion.

AUTHOR/ARTICLE INFORMATION

Submitted November 1, 2000; accepted November 6, 2000.

Address correspondence and reprint requests to: San Francisco Heart Institute, Seton Medical Center, 1900 Sullivan Ave., Daly City, CA 94015-2229, Phone: (415) 991-6712, Fax: (415) 755-7315