8-year Experience With Tecab And Graft Patency
Changqing Gao, Huajun Zhang, Ming Yang, Nan Cheng, Gang Wang, Yang Wu.
PLA General Hospital, Beijing, China.
Totally Endoscopic Coronary Artery Bypass Grafting: 8-year Experience and Follow-up of Graft Patency
Changqing Gao1*, Huajun Zhang1, Ming Yang1, Yang Wu1, Nan Cheng1
1Department of Cardiovascular Surgery, PLA General Hospital, Beijing, 100853, China
*corresponding author Tel: +86 10 66938035. Email: gaochq301.com
To summarize the 8-year surgical experience with totally endoscopic coronary artery bypass grafting (TECAB) and demonstrate the long-term follow-up results of the graft patency.
Between March 2007 and November 2016, a total of 114 consecutive patients ( 96 male) at a mean age of 58 years (range, 36 to 78 years) and EuroSCORE of 1.1±1.3 underwent off-pump TECAB with da Vinci Surgical System (Intuitive Surgical, USA) in our institution. Skeletonized left internal mammary artery (LIMA) conduit was used to graft left anterior descending (LAD) artery with S18 U-clips and the blood flow in LIMA graft was measured with Medistim VeriQC system (Medistim ASA, Norway). The patients were followed after surgery and the coronary angiography or CT angiogram (CTA) was performed to evaluate LIMA graft patency.
All cases (n=114) were successfully performed by single console surgeon (Gao C.) with single LIMA graft to LAD (100%). There was no operative death or conversion to median sternotomy. The mean of operation duration was 219 ± 58 min. The blood flow of LIMA graft was (36.8±18) ml/min after TECAB. No major complication was observed after operation. The postoperative ventilation time was 13.9 ± 4.0 hours. The chest draining volume was 417.4 ±274.8 ml. Coronary angiography or CTA showed 100% graft patency before discharge. During the follow-up, LIMA graft patency was 98.8% at 1 year, 97.8% at 2 years after surgery, and 97.1% at 3 to 5 years after surgery.
Off-pump TECAB using LIMA to graft LAD is a safe and effective procedure for single vessel disease and the long-term graft patency is excellent.
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