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Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study
BACKGROUND: Minimally invasive coronary surgery–coronary artery bypass grafting (MICS CABG) is well adopted in clinical practice. However, this procedure did not really achieve conventional complete revascularization. The present study aimed to explore the feasibility and safety of conventional reva...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641355/ https://www.ncbi.nlm.nih.gov/pubmed/36389332 http://dx.doi.org/10.21037/jtd-22-1162 |
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author | Yang, Dongyan Zhang, Kai Li, Junshan Wei, Dong Ma, Jing Wang, Yulong Yang, Yin Li, Jinghui Bai, Yunpeng Zhang, Yuhui Gao, Jing Wang, Lianqun |
author_facet | Yang, Dongyan Zhang, Kai Li, Junshan Wei, Dong Ma, Jing Wang, Yulong Yang, Yin Li, Jinghui Bai, Yunpeng Zhang, Yuhui Gao, Jing Wang, Lianqun |
author_sort | Yang, Dongyan |
collection | PubMed |
description | BACKGROUND: Minimally invasive coronary surgery–coronary artery bypass grafting (MICS CABG) is well adopted in clinical practice. However, this procedure did not really achieve conventional complete revascularization. The present study aimed to explore the feasibility and safety of conventional revascularization via the left thoracotomy (8–10 cm) approach. METHODS: From January 2020 to March 2022, a total of 97 consecutive patients who needed coronary artery revascularization were operated on using this technique. The patients’ preoperative, intraoperative, postoperative, and follow-up data were collected. Perioperative variables were compared between the single graft and non-single graft groups. All patients received dual-source computerized tomographic angiography at 1-week postoperatively to evaluate the graft patency and detect pulmonary embolism and aortic dissection. The patients were followed up for 3–27 months. RESULTS: The mean age of the entire cohort was 61.5±8.8 years, there were 16 (16.5%) female patients, and 1–4 grafts were performed per patient. There were no conversions to median sternotomy or on-pump CABG. The average number of grafts was 1.9±0.9, and that of the non-single graft group was 2.5±0.6. Among the 97 included patients, one patient in the single graft group suffered from aspiration pneumonia after a stroke and died. The 30-day mortality was 1.0% (one patient), one patient required re-exploration for bleeding (1.1%), and a total of 191 grafts were performed. All grafts were unobstructed except for one graft to the obtuse marginal branch (OM) (0.5%). Follow-up was performed by phone or via outpatient visits and was available for 92 patients (95%). During the follow-up period, 1 (1.1%) patient suffered an acute myocardial infarction and received percutaneous coronary intervention with no redo-surgery. All patients are alive and angina-free. CONCLUSIONS: Left thoracotomy for conventional revascularization is a safe procedure for appropriately selected patients, with few early complications and good early and mid-term results. More cases are ongoing and long-term results are in observation. |
format | Online Article Text |
id | pubmed-9641355 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-96413552022-11-15 Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study Yang, Dongyan Zhang, Kai Li, Junshan Wei, Dong Ma, Jing Wang, Yulong Yang, Yin Li, Jinghui Bai, Yunpeng Zhang, Yuhui Gao, Jing Wang, Lianqun J Thorac Dis Original Article BACKGROUND: Minimally invasive coronary surgery–coronary artery bypass grafting (MICS CABG) is well adopted in clinical practice. However, this procedure did not really achieve conventional complete revascularization. The present study aimed to explore the feasibility and safety of conventional revascularization via the left thoracotomy (8–10 cm) approach. METHODS: From January 2020 to March 2022, a total of 97 consecutive patients who needed coronary artery revascularization were operated on using this technique. The patients’ preoperative, intraoperative, postoperative, and follow-up data were collected. Perioperative variables were compared between the single graft and non-single graft groups. All patients received dual-source computerized tomographic angiography at 1-week postoperatively to evaluate the graft patency and detect pulmonary embolism and aortic dissection. The patients were followed up for 3–27 months. RESULTS: The mean age of the entire cohort was 61.5±8.8 years, there were 16 (16.5%) female patients, and 1–4 grafts were performed per patient. There were no conversions to median sternotomy or on-pump CABG. The average number of grafts was 1.9±0.9, and that of the non-single graft group was 2.5±0.6. Among the 97 included patients, one patient in the single graft group suffered from aspiration pneumonia after a stroke and died. The 30-day mortality was 1.0% (one patient), one patient required re-exploration for bleeding (1.1%), and a total of 191 grafts were performed. All grafts were unobstructed except for one graft to the obtuse marginal branch (OM) (0.5%). Follow-up was performed by phone or via outpatient visits and was available for 92 patients (95%). During the follow-up period, 1 (1.1%) patient suffered an acute myocardial infarction and received percutaneous coronary intervention with no redo-surgery. All patients are alive and angina-free. CONCLUSIONS: Left thoracotomy for conventional revascularization is a safe procedure for appropriately selected patients, with few early complications and good early and mid-term results. More cases are ongoing and long-term results are in observation. AME Publishing Company 2022-10 /pmc/articles/PMC9641355/ /pubmed/36389332 http://dx.doi.org/10.21037/jtd-22-1162 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Yang, Dongyan Zhang, Kai Li, Junshan Wei, Dong Ma, Jing Wang, Yulong Yang, Yin Li, Jinghui Bai, Yunpeng Zhang, Yuhui Gao, Jing Wang, Lianqun Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
title | Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
title_full | Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
title_fullStr | Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
title_full_unstemmed | Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
title_short | Ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
title_sort | ninety-seven cases of experiences with the left thoracotomy approach for off-pump conventional revascularization: a retrospective cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641355/ https://www.ncbi.nlm.nih.gov/pubmed/36389332 http://dx.doi.org/10.21037/jtd-22-1162 |
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