J.Jpn. Surg. Soc.. 117(2): 130-135, 2016

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Feature topic

MINIMALLY INVASIVE MULTIVESSEL CORONARY ARTERY BYPASS GRAFTING VIA SMALL LEFT THORACOTOMY

Although a minithoracotomy approach has several advantages over a sternotomy approach in terms of superior cosmesis and faster recovery, coronary artery bypass grafting (CABG) via sternotomy has been the gold standard for revascularization in multivessel coronary artery disease. Recently, nonsternotomy approaches, including the minimally invasive cardiac surgery CABG (MICS-CABG) via small left thoracotomy, have emerged as safe, effective alternatives. Excellent clinical results have been reported including equivalent mid-term graft patency as compared with a sternotomy approach. Successful use of bilateral internal thoracic arteries in MICS-CABG has also been reported. Although the durability of this approach and its impact on long-term survival have yet to be confirmed, and there is a certain technical learning curve, MICS-CABG will be one important option to treat multivessel coronary artery disease.

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