HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Johannes Bonatti Herbert Hangler Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bonatti, J. Articles by Katzgraber, F. Search for Related Content PubMed PubMed Citation Articles by Bonatti, J. Articles by Katzgraber, F.

Eur J Cardiothorac Surg 1998;14:S71-S75
© 1998 Elsevier Science NL

Anatomical studies concerning technical feasibility of minimally invasive axillocoronary bypass grafting ¹

^a University Clinic of Surgery/Cardiac Surgery Innsbruck, Innsbruck, Austria
^b Institute of Forensic Medicine, University of Innsbruck, Innsbruck, Austria

^* Corresponding author. University Clinic of Surgery/Cardiac Surgery, Anichstrasse 35, A-6020 Innsbruck, Austria. Tel.: +43 512 5042529; fax +43 512 5042528; e-mail: johannes.o.bonatti@uibk.ac.at

Objective: Minimally invasive multiple vessel revascularization has been accomplished using all arterial graft concepts and aortocoronary vein grafts. The aim of the present study was to determine the technical feasibility of minimally invasive axillary artery to coronary artery vein grafting in the human cadaver. Methods: In seven human cadavers the axillary artery was approached bilaterally via a small incision above the anterior axillary fold. The left anterior descending coronary artery system and the right coronary artery system were exposed via a left anterior minithoracotomy and a subxiphoid incision respectively. Saphenous vein grafts were anastomosed end to side to the axillary artery and brought to the target vessels following a transpleural route. The vein grafts were then sutured to the left anterior descending artery and to the posterior descending artery through the mini-incisions. Results: Axillocoronary bypass grafting to the left anterior descending artery was performed successfully in seven cases, axillocoronary bypass grafting to the posterior descending artery was accomplished in six cases. The mean length of the mini-incisions was as follows: left axillary artery exposure 5.1±1.5 cm, right axillary artery exposure 5.5±2.0 cm, left anterior minithoracotomy 10.8±1.9 cm, subxiphoid incision 9.4±1.9 cm. The mean length of saphenous vein required for the left axillary artery to left anterior descending artery bypass was 18.9±2.8 cm, the mean length of vein required for the right axillary artery to posterior descending artery bypass was 26.0±2.6 cm. This was significantly longer than the aortocoronary route (ascending aorta to left anterior descending artery 12.5±2.2 cm P=0.0001, ascending aorta to posterior descending artery 18.3±2.9 cm P<0.0001). Conclusion: From this study we conclude that minimally invasive axillocoronary venous bypass grafting to the left anterior descending artery system and to the distal right coronary artery system is technically feasible in the human cadaver.

Key Words: Coronary artery bypass • Minimally invasive • Axillary artery • Saphenous vein graft

This article has been cited by other articles:

				A. M. Tarakji and M. C. Sinclair Should axillary artery to coronary artery bypass be part of the cardiac surgeon's armamentarium? Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 65 - 68. [Abstract] [Full Text] [PDF]

				J. Bonatti, H. Hangler, D. Oturanlar, L. Posch, L. C Muller, W. Voelckel, B. Schwarz, and G. Bodner Beating heart axillocoronary bypass for management of the untouchable ascending aorta in coronary artery bypass grafting Eur. J. Cardiothorac. Surg., November 1, 1999; 16(suppl_2): S18 - S23. [Abstract] [Full Text] [PDF]