Endoscopic Internal Thoracic Artery Harvesting with Changes in Scope Position

Authors

  • Yoshihiro Goto, MD Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
  • Sho Takagi, MD, PhD Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
  • Junji Yanagisawa, MD Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
  • Akio Nakasu, MD Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
  • Yasuhide Okawa, MD Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan

DOI:

https://doi.org/10.1532/hsf.4195

Keywords:

coronary bypass graft (CABG), endoscopic surgery, LITA harvesting, minimally invasive direct coronary artery bypass

Abstract

Although minimally invasive direct coronary artery bypass (MIDCAB) is a less invasive procedure, internal thoracic artery (ITA) harvesting is difficult. A 65-year-old woman was advised to undergo MIDCAB for recurrent in-stent restenosis. We harvested the ITA using three-dimensional endoscopy without robotics and determined the scope position using enhanced computed tomography. We changed the camera installation between the wound and the camera port, according to the harvesting site with a harmonic scalpel using the skeletonized technique. We harvested the ITA from the subclavian vein level superiorly to the xyphoid process level inferiorly.

References

Benetti FJ, Ballester C. 1995. Use of thoracoscopy and a minimal thoracotomy, in mammary-coronary bypass to left anterior descending artery, without extracorporeal circulation. Experience in 2 cases. J Cardiovasc Surg. 36:159-61.

Gong W, Cai J, Wang Z, et al. 2016. Robot-assisted coronary artery bypass grafting improves short-term outcomes compared with minimally invasive direct coronary artery bypass grafting. J Thorac Dis. 8:459–68.

Itagaki S, Reddy RC. 2013. Options for left internal mammary harvest in minimal access coronary surgery. J Thorac Dis 5 Suppl. 6:S638–40.

Loulmet D, Carpentier A, d'Attellis N, et al. 1999. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg. 118:4–10.

Srivastava S, Gadasalli S, Agusala M, et al. 2010. Beating heart totally endoscopic coronary artery bypass. Ann Thorac Surg. 89:1873–80.

Tomita S, Watanabe G, Tabata S, et al. 2006. Total endoscopic beating-heart coronary artery bypass grafting using a new 3D imaging system. Innovations. 1:243–6.

Yang M, Wu Y, Wang G, et al. 2015. Robotic total arterial off-pump coronary artery bypass grafting: seven-year single-center experience and long-term follow-up of graft patency. Ann Thorac Surg. 100:1367–73.

Published

2021-11-17

How to Cite

Yoshihiro, G., Takagi, S., Yanagisawa, J., Nakasu, A., & Okawa, Y. (2021). Endoscopic Internal Thoracic Artery Harvesting with Changes in Scope Position. The Heart Surgery Forum, 24(6), E950-E951. https://doi.org/10.1532/hsf.4195

Issue

Section

Articles