Recently, in the Center of Innovative Cardiac Surgery in Feofania clinical hospital was performed minimally invasive coronary bypass grafting (MIDCABG, off-pump LIMA-LAD).
The patient has been suffering from coronary artery disease for a long time and had 2 heart attacks in the area of blood supply of the right coronary artery and had undergone 2 stenting of the right coronary artery.
Due to repeated attacks of chest pain, the patient again had asked to interventional cardiologists, and coronary angiography was performed. The narrowing of the proximal left anterior descending artery up to 70% was detected.
To choose the final tactics, the patient underwent stress echocardiography, which allow to clear up the situation: marked hypokinesis of the intact myocardium and a decrease in ejection fraction to 15% (from 45%) with akinesis of the apex and hypokinesis of the left ventricle lateral wall was observed.
According to the ESC/EACTS Guidelines on Myocardial Revascularization for yr. 2018, it was decided to perform an arterial revascularization through minithoracotomy.
In the next photo, you can see a 5.5 cm incision. Almost invisible to the eye, just along the fold under the pectoral muscle (as invisible as possible after healing).
During the operation, the patency of the graft was assessed using a flowmeter – the volumetric blood flow through the shunt was more than 170 ml/min.