How To Do An Endoscopic Atraumatic Coronary Artery Bypass (endo-acab) With Thoracoscopic Left Internal Mammary Artery Harvesting.
Sotirios Marinakis, PhD.
CHU Charleroi, Lodelinsart, Belgium.
BACKGROUND: Minimally invasive procedures for coronary revascularization are in practice since more than 20 years. However, technical difficulty, steep learning curves and absence of training programs did not permit a wide acceptance of the technique. This video shows a step-by-step approach on how to perform an endoscopic atraumatic coronary artery bypass (endo-ACAB) with thoracoscopic left internal mammary artery (LIMA) harvesting.
METHODS: A short video, single patient, endo-ACAB procedure was compiled from patient installation to wound closure.
RESULTS: We started our minimal invasive coronary artery program on July 2018 and since then more than 70 procedures were performed by a single surgeon. With ongoing experience, complexity of coronary revascularization has evolved from single vessel to multivessel disease and anesthesiologic and surgical protocols have also evolved.
CONCLUSIONS: Endo-ACAB is a technically demanding operation. Thoracoscopic LIMA harvesting and pericardial opening during thoracoscopy permit an excellent visualization of target coronary vessels with better evaluation of optimal skin incision.
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