New method of bimammary coronary artery bypass grafting through left-sided thoracotomy on working heart

Abstract

OBJECTIVE. The authors developed a low invasive method of bimammary coronary artery bypass grafting (CABG) of minimum two arteries through left-sided thoracotomy. MATERIAL AND METHODS. The left internal thoracic artery was used for bypass grafting of anterior interventricular artery according to V.I. Kolesov method. Anastomosis of the right interventricular artery with conduit (from autoartery or autovein) was performed by using extrapleural way in the second intercostal space from the right of the breast. Conduit was lengthened behind the sternum to pericardium cavity in order to create the second distal anastomosis with branch of coronary artery. RESULTS. The operations (10 cases) were conducted at the period from October 2015 to December 2016. The second distal anastomosis between conduit and coronary artery was performed with diagonal artery in 1 case, with branch of blunt edge in 5 cases and with posterior interventricular branch in 4 cases. Tolerance of operation and early postoperative period were satisfactory. CONCLUSIONS. New method of bimammary coronary artery bypass allowed doctors to perform revascularization minimum of two coronary vessels on working heart by avoiding manipulations on aorta and the sternum.

Keywords

• operation
• arteries
• bypass grafting
• bimammary