Endoscopic harvest internal mammary artery with harmonic scalpel in minimally invasive coronary artery bypass grafting
10.3760/cma.j.cn112434-20250102-00001
- VernacularTitle:全腔镜下超声刀获取乳内动脉在微创冠状动脉旁路移植中的应用
- Author:
Xiuxiu ZHANG
1
;
Peisong WANG
1
;
Yichang SONG
1
;
Hao WANG
1
;
Yuxin XIAO
1
;
Xi YANG
1
;
Dapeng YU
1
Author Information
1. 东阿县人民医院（聊城市心脏病临床医学研究中心）心脏大血管外科，山东聊城 252200
- Publication Type:Journal Article
- Keywords:
Harmonic scalpel;
Thoracoscopy;
Left internal mammary artery;
Minimally invasive coronary artery bypass grafting
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(7):411-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Utilizing the principles of mechanical vibrations dissections and low-temperature coagulation of harmonic scalpel, and combining the magnifying effect of 3D thoracoscopy and the advantage of low trauma, we used harmonic scalpel to harvest the left internal mammary artery (LIMA) under thoracoscopy, and explored the feasibility and early effect of harmonic scalpel in minimally invasive coronary artery bypass grafting (MICABG).Methods:A total of 488 patients who underwent MICABG from July 2021 to December 2023 in Dong E Hospital were collected. Among them, 347 patients was harvested using harmonic scalpel under thoracoscopy. Following anastomosis, the blood flow and pulsatility index (PI) from the graft to the target vessel were determined using a transit time flow meter (MiraQ, Medistim, Norway), and patency was checked. Data from 347 patients were analyzed.Results:All 347 patients were performed under non-extracorporeal circulation and successful graft patency was achieved in all patients. Analysis of 79 patients revealed a median time to LIMA acquisition of 32 min and a median length of acquisition of 15 cm. No graft-related events or complications occurred in any of the patients, and 2 patients died postoperatively. During a median follow-up of 12.1 months, only one patient experienced graft occlusion necessitating intervention.Conclusion:The utilization of harmonic scalpel for LIMA harvesting in MICABG is feasible and yields stable early results.
