obot-assisted bilateral internal mammary arteries harvesting for off-pump coronary artery bypass grafting with 5 grafts by minimally invasive small incision: A case report
- VernacularTitle:机器人辅助双侧乳内动脉获取微创小切口五支冠状动脉旁路移植一例
- Author:
Bing LIU
1
;
Nan CHENG
1
;
Hua SHEN
1
;
Rong WANG
1
Author Information
1. Department of Cardiovascular Surgery, The First Medical Center of Chinese PLA General Hospital, 100853, Beijing, P.R.China
- Publication Type:Journal Article
- Keywords:
Robot-assisted surgery;
bilateral internal mammary arteries harvesting;
minimally invasive incision;
coronary artery bypass graftting with 5 grafts;
case report
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(06):650-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce the method and preliminary experience of robot-assisted bilateral internal mammary arteries (BIMA) harvesting for off-pump coronary artery bypass grafting (OPCAB) with 5 grafts via left anterolateral minithoracotomy. Methods BIMA were harvested using the da Vinci robotic surgical system, and the right internal mammary artery (RIMA) was pulled out of the thoracic cavity through right second intercostal space. Intercepting the distal part of the RIMA for the BIMA composite Lima-Rima Y graft and anastomosing the great saphenous vein with remaining RIMA end to end. The Y graft anastomosed with left anterior descending (LAD) branch and diagonal branches (DIAG), artery-vein graft sequentially anastomosed with blunt round branch, left ventricular posterior branch and posterior descending branch. Results The operation succeeded without hemodynamic instability and intra aortic balloon pump (IABP) implantation or cardiopulmonary bypass. The blood flow of Y graft was 24 mL/min, and the blood flow of artery-vein graft was 30 mL/min. Ventilator assistance time was 35 hours, ICU staying time was 62 hours, and postoperative myocardial enzymes increased temporarily. Postoperative coronary CTA showed that all the grafts were patency, and cardiac ultrasound indicated that the heart function was normal. The patient cured and discharged from hospital 7 days after operation. Conclusion Robot-assisted bilateral internal mammary artery harvesting for OPCAB with 5 grafts via left anterolateral minithoracotomy is feasible, which can achieve complete revascularization.
