Step 1 Surgical Anatomy ◆ Postinfarction ventricular septal defects (VSDs) are classified as occurring in three locations—apical, anterior, and posteroinferior ( Fig. 8.1 ). Most common is an anterior or apical defect caused by anterior septal myocardial infarction after occlusion…
Introductory Considerations ◆ The goal of any minimally invasive procedure is to achieve the least surgical trauma possible and to carry out the intervention in a port-only approach. After unsuccessful attempts to perform endoscopic coronary bypass surgery using long-shafted thoracoscopic…
Definition and Rationale ◆ Hybrid coronary revascularization (HCR) is defined as the combination of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) to treat multivessel coronary artery disease (CAD). HCR most commonly combines a minimally invasive CABG procedure…
See Videos 5.1 to 5.10 on ExpertConsult.com . Minimally Invasive Cardiac Surgery–Coronary Artery Bypass Grafting (MICS CABG) ◆ This technique enables revascularization with a similar configuration as that in a sternotomy technique, using left internal thoracic artery (LITA) harvesting and…
◆ The ability to perform coronary artery bypass grafting (CABG) competently without the use of cardiopulmonary bypass is an important skill for all cardiac surgeons. There are cases in which a safe coronary revascularization procedure can only be performed as…
Step 1 Surgical Anatomy ◆ The named epicardial coronary arteries that serve as the distal anastomotic targets for coronary artery bypass grafting (CABG) are most commonly located just deep to the epicardial fat and superficial to the myocardium. The arteries,…
Step 1 Surgical Anatomy 1 Ascending Aorta ◆ Cannulation sites on the ascending aorta should be as high as safely possible. Surgeons today more frequently perform complete arterial revascularization, which in some cases may require delicate proximal anastomoses of arterial…
◆ The median sternotomy was reintroduced by Julian in 1957, which was already described by Milton in 1897. The median sternotomy has become a gold standard approach for cardiac procedures, with subsequent developments in cardiac surgery. The skin incision could…