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Complete off-pump arterial revascularization from mini-thoracotomy

A young patient (53 years old) has recently had an ischemic heart disease and a few months ago had emergency stenting because of acute coronary syndrome.

For recurrent angina, computed coronary angiography was performed.

Calcification LAD and D1 on CT coronarography

Multiple coronary artery disease was confirmed. To resolve the issue of further treatment tactics, it was decided to conduct catheter angiography.

Proximal circumflex stenosis one view
Proximal circumflex stenosis another projection
Stenosis of the LAD with extension to the diagonal branch

From the mini thoracotomy we endoscopically harvested both internal thoracic arteries. The right internal thoracic is connected to the radial artery and sequentially anastomosed into the branch of the blunt edge and the diagonal branch. The left internal thoracic anastomosed with the LAD.

Photos 1-2 show an incision of 7 cm. Almost invisible to the eye, exactly in the fold under the pectoral muscle (maximally invisible after healing).

Photo 1
Photo 2

Тhe radial artery has also been harvested endoscopically (2.0 cm incision shown on photo 3).

Photo 3

The patient was discharged on the 5th postoperative day uneventfully.