International Society For Minimally Invasive Cardiothoracic Surgery

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3d Video Assisted Lima Harvesting And Midcab
Mustafa Bahadir Inan, Fatih Gumus, Ali Ihsan Hasde, Evren Ozcinar, Mehmet Cakici, Alper Ozgur, Mustafa Serkan Durdu, Ahmet Ruchan Akar, Kemalettin Ucanok.
Ankara University, ankara, Turkey.

Background: Minimally invasive coronary artery bypass surgery in selected patients can be performed safely and efficiently, with the markedly reduced post-operative length of stay when compared to conventional surgical revascularization. A left thoracotomy is preferred during MIDCAB for both LİMA harvesting and performing the anastomosis. However, LİMA harvesting is sometimes challenging via the thoracotomy, which makes some surgeons prefer not to harvest the proximal LİMA. We reported our experience in 3D video-assisted LIMA harvesting in MIDCAB surgery. Methods: Twelve patients who underwent MIDCAB surgery had 3D video-assisted LIMA harvesting. In these patients, LIMA was harvested in the closed chest through 3 ports, 2 for surgical equipment and one for the 3D camera. Following the harvest, thoracotomy was performed for off-pump LAD-LIMA anastomosis. Results: All the patients underwent one vessel MIDCAB surgery and LIMA was anastomosed to the LAD, following video-assisted harvesting. LIMA was harvested including the first branch and finished at the level of the distal bifurcation. Mean harvest duration was 31+9 minutes, and mean operation time was 107+19minutes. All the LİMA grafts harvested was anastomosed and there was no sternotomy conversion. Conclusions: Minimally invasive coronary procedures are becoming an important option for the treatment of coronary artery disease especially with the addition of 3D visions and robotic arms lately. 3D video assistance in closed chest allows LİMA harvesting in a safe and efficient way.

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