摘要
Introduction: Here we will describe the actual surgical technique to perform the left mammary artery bypass to the left anterior descending artery, and the results of this operation in the Benetti Foundation in the last 20 years. Materials and Methods: The inclusion criteria for this operation were patients with a demonstrated predominant ischemia by functional test. In the patients with double, triple vessels disease or left main, the age was more than 65 years or and Euro score Risk of surgery of more than 4. The exclusion criteria were patients with more areas of ischemia and lesions that involved a considerable territory apart from the Lad and good candidates for surgery are younger than 65 years or the Euro score Risk of surgery were less than 4. Seventy patients were operated in the Foundation through LIMA to LAD Anastomosis with the MINI OPCABG technique. The average Preoperative Risk Euroscore was 3,5. Surgical Technique after open the lower part of the sternum, the left mammary artery is dissected around 8 cm. The pericardium is open and the mammary is connected to the left anterior descending. Results: Operative mortality in this series was 0%. One patient was converted to sternotomy Off Pump (1, 4%). None of the grafts were revised after the measure with the Medistim System. 55 (79%) were extubated in the operating room. The average Hospitalization stay were 60 hours (D +_17 ci 95%), 16 patients with Lima to LAD were restudied in the initially experience with 100% patency, at 144 months, 82% of the patients were alive and 68% asymptomatic. Conclusion: More clinical experience is important to find the definitive indications of this technique;and better technologies are required to be able to standardize this operation in definitive form.
Introduction: Here we will describe the actual surgical technique to perform the left mammary artery bypass to the left anterior descending artery, and the results of this operation in the Benetti Foundation in the last 20 years. Materials and Methods: The inclusion criteria for this operation were patients with a demonstrated predominant ischemia by functional test. In the patients with double, triple vessels disease or left main, the age was more than 65 years or and Euro score Risk of surgery of more than 4. The exclusion criteria were patients with more areas of ischemia and lesions that involved a considerable territory apart from the Lad and good candidates for surgery are younger than 65 years or the Euro score Risk of surgery were less than 4. Seventy patients were operated in the Foundation through LIMA to LAD Anastomosis with the MINI OPCABG technique. The average Preoperative Risk Euroscore was 3,5. Surgical Technique after open the lower part of the sternum, the left mammary artery is dissected around 8 cm. The pericardium is open and the mammary is connected to the left anterior descending. Results: Operative mortality in this series was 0%. One patient was converted to sternotomy Off Pump (1, 4%). None of the grafts were revised after the measure with the Medistim System. 55 (79%) were extubated in the operating room. The average Hospitalization stay were 60 hours (D +_17 ci 95%), 16 patients with Lima to LAD were restudied in the initially experience with 100% patency, at 144 months, 82% of the patients were alive and 68% asymptomatic. Conclusion: More clinical experience is important to find the definitive indications of this technique;and better technologies are required to be able to standardize this operation in definitive form.
