HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard V. Anderson Eugene A. Grossi Robert M. Applebaum Aubrey C. Galloway Stephen B. Colvin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ribakove, G. H. Articles by Colvin, S. B. Search for Related Content PubMed PubMed Citation Articles by Ribakove, G. H. Articles by Colvin, S. B.

J Thorac Cardiovasc Surg 1998;115:1101-1110
© 1998 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

Minimally invasive port-access coronary artery bypass grafting with early angiographic follow-up: Initial clinical experience

Read at the Twenty-third Annual Meeting of The Western ThoracicSurgical Association, Napa, Calif., June 25-28, 1997.

Received for publication July 8, 1997. Revisions requested July 25, 1997; revisions received Jan. 6, 1997. Accepted for publication Jan. 14, 1998. Address for reprints: Greg H. Ribakove, MD, 530 First Ave., Suite6D, New York University Medical Center, New York, NY 10016.

Abstract

Objective: New techniques for minimally invasive coronary artery bypass grafting have recently emerged. The purpose of this study was to determine the safety and efficacy of Port-Access (Heartport, Inc., Redwood City, Calif.) coronary revascularization and to evaluate with angiography the early graft patency rate with this new approach. Methods: From October 1996 to May 1997, 31 patients underwent Port-Access coronary artery bypass grafting with an anterior minithoracotomy and endovascular-occlusion cardiopulmonary bypass. There were 26 men and 5 women with a mean age of 62 years (range 42 to 82 years). Fifteen patients underwent single bypass; 12 patients underwent double bypass, and 4 patients underwent triple bypass. Bypass conduits included the left internal thoracic artery (n = 30), right internal thoracic artery (n = 2), radial artery (n = 10), and saphenous vein (n = 6). Three sequential grafts were used. Angiographic studies of the bypass grafts were performed in 27 of 31 patients (87%). Results: There were no deaths, neurologic deficits, myocardial infarctions, or aortic dissections. Conversion to sternotomy was not required in any case. There were two reoperations for bleeding, one reoperation for tamponade, and one reoperation for pulmonary embolus. Postoperative angiography revealed anastomotic patency of the left internal thoracic artery to left anterior descending artery in 26 of 26 grafts (100%) with overall anastomotic patency in 43 of 44 grafts (97.7%). Conclusion: These results demonstrate that Port-Access coronary artery bypass can be performed accurately and safely with acceptable morbidity. This approach allows for multivessel revascularization on an arrested, protected heart with excellent anastomotic precision and reproducible early graft patency.

This article has been cited by other articles:

				T. C. Mineo Epidural anesthesia in awake thoracic surgery Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 13 - 19. [Abstract] [Full Text] [PDF]

				F. Farhat, M. Vergnat, P. Blanc, P. Chiari, and O. Jegaden Which place for Port AccessTM surgery in coronary artery bypass grafting? A mid-term follow up study Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 71 - 74. [Abstract] [Full Text] [PDF]

				B. E. Muhs, A. C. Galloway, M. Lombino, M. Silberstein, E. A. Grossi, S. B. Colvin, P. Lamparello, G. Jacobowitz, M. A. Adelman, C. Rockman, et al. Arterial Injuries from Femoral Artery Cannulation with Port Access Cardiac Surgery Vascular and Endovascular Surgery, March 1, 2005; 39(2): 153 - 158. [Abstract] [PDF]

				T. Aybek, P. Kessler, S. Dogan, G. Neidhart, M. F. Khan, G. Wimmer-Greinecker, and A. Moritz Awake coronary artery bypass grafting: utopia or reality? Ann. Thorac. Surg., April 1, 2003; 75(4): 1165 - 1170. [Abstract] [Full Text] [PDF]

				T J Spyt and A C De Souza Minimally invasive therapy and robotics: Treatments in ischaemic heart disease Br. Med. Bull., October 1, 2001; 59(1): 261 - 268. [Full Text] [PDF]

				G. J. Van Nooten Multicenter experience with the remote access perfusion (RAP) catheter Ann. Thorac. Surg., September 1, 2001; 72(3): S1065 - 1068. [Abstract] [Full Text] [PDF]

				J. Siebert, J. Rogowski, D. Jagielak, L. Anisimowicz, R. Lango, and M. Narkiewicz Atrial fibrillation after coronary artery bypass grafting without cardiopulmonary bypass Eur. J. Cardiothorac. Surg., May 1, 2000; 17(5): 520 - 523. [Abstract] [Full Text] [PDF]

				D. D. Glower, J. Komtebedde, F. M. Clements, N. P. Debruijn, M. Stafford-Smith, and M. F. Newman Direct aortic cannulation for port-access mitral or coronary artery bypass grafting Ann. Thorac. Surg., November 1, 1999; 68(5): 1878 - 1880. [Abstract] [Full Text] [PDF]

				E. A. Grossi, M. A. Groh, E. A. Lefrak, G. H. Ribakove, R. A. Albus, A. C. Galloway, and S. B. Colvin Results of a prospective multicenter study on port-access coronary bypass grafting Ann. Thorac. Surg., October 1, 1999; 68(4): 1475 - 1477. [Abstract] [Full Text] [PDF]

				D. D. Glower, F. M. Clements, N. P. Debruijn, M. Stafford-Smith, R. D. Davis, K. P. Landolfo, and P. K. Smith Comparison of direct aortic and femoral cannulation for port-access cardiac operations Ann. Thorac. Surg., October 1, 1999; 68(4): 1529 - 1531. [Abstract] [Full Text] [PDF]

				L. C. Siegel Port-Access Cardiac Surgery: Anesthetic Techniques, Equipment, Applications, Experience, and Outcomes Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1999; 3(2): 74 - 84. [Abstract] [PDF]

				M. S. Ghotbi and J. G. Ramsay Minimally Invasive Cardiac Surgery: Impact on Resource Usage, Costs, Length of Stay, and Return to Function Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1999; 3(2): 126 - 135. [Abstract] [PDF]

				J. M Toomasian Cardiopulmonary bypass for less invasive procedures Perfusion, July 1, 1999; 14(4): 279 - 286. [PDF]

				A. C. Galloway, R. J. Shemin, D. D. Glower, J. H. Boyer Jr, M. A. Groh, R. E. Kuntz, T. A. Burdon, G. H. Ribakove, B. A. Reitz, and S. B. Colvin First report of the port access international registry Ann. Thorac. Surg., January 1, 1999; 67(1): 51 - 58. [Abstract] [Full Text] [PDF]