Cirurgia de revascularização do miocárdio minimamente invasiva com utilização da videotoracoscopia / Minimally Invasive Myocardial Bypass Surgery Using Video-Assisted Thoracoscopy
Arq. bras. cardiol
; 68(2): 107-111, Fev. 1997. ilus
Artigo
em Português
| LILACS
| ID: lil-320368
Biblioteca responsável:
BR1.1
RESUMO
PURPOSE:
In order to associate the major benefits of the coronary artery bypass graft (CABG) with a less aggressive procedure minimally invasive coronary artery bypass graft (MICABG) has been utilized. The aim of the work is to report our initial experience with this technical approach, using video assisted thoracic surgery (VATS) to facilitate the operation.METHODS:
Twenty-six patients, 19 males with ages from 44 to 83 years old, and having isolated lesion of the anterior descending artery were operated upon. Left anterior minithoracotomy of 8-10 cm was performed at the fourth intercostal space. Through this incision the optical device for VATS as well as the surgical instruments were placed in order to provide the complete left internal mammary artery (LIMA) dissection. Bypass circulation was not used and cardiac rate was decreased with the use of intravenous betablockers. For LIMA--anterior descending artery anastomosis, proximal and distal tourniquets were used and 1.5 mg/kg of heparin was intravenously administered.RESULTS:
All patients presented satisfactory postoperative evolution, being discharged from the hospital at 72 h after surgery in the majority of the cases. There were delay in two patients healing of incisions and 25 patients have remained asymptomatic, with a mean in postoperative follow-up of four months. One patient died in the second postoperative month due to stroke.CONCLUSION:
MICABG makes the surgery possible with better esthetic effect, lower cost and enables faster recovery than the conventional one. The use of VATS through the thoracotomy itself, allows the LIMA dissection without other incisions. It also permitted more ample dissection of the LIMA when compared to minithoracotomy without VATS.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Toracoscopia
/
Doença das Coronárias
/
Revascularização Miocárdica
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Idoso, 80 anos ou mais
/
Feminino
/
Humanos
/
Masculino
Idioma:
Português
Revista:
Arq. bras. cardiol
Assunto da revista:
Cardiologia
Ano de publicação:
1997
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
INCOR/BR