tailieunhanh - Báo cáo y học: "Is there an optimal minimally invasive technique for left anterior descending coronary artery bypas"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Is there an optimal minimally invasive technique for left anterior descending coronary artery bypass? | Jegaden et al. Journal of Cardiothoracic Surgery 2011 6 37 http content 6 1 37 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Is there an optimal minimally invasive technique for left anterior descending coronary artery bypass Olivier Jegaden Fabrice Wautot Thomas Sassard Isabella Szymanik Abdel Shafy Joel Lapeze and Fadi Farhat Abstract Background The aim of this retrospective study was to evaluate the clinical outcome of three different minimally invasive surgical techniques for left anterior descending LAD coronary artery bypass grafting CABG Port-Access surgery PA-CABG minimally invasive direct CABG MIDCAB and off-pump totally endoscopic CABG TECAB . Methods Over a decade 160 eligible patients for elective LAD bypass were referred to one of the three techniques 48 PA-CABG 53 MIDCAB and 59 TECAB. In MIDCAB group Euroscore was higher and target vessel quality was worse. In TECAB group early patency was systematically evaluated using coronary CT scan. During follow-up mean years cumulated 438 years symptom-based angiography was performed. Results There was no conversion from off-pump to on-pump procedure or to sternotomy approach. In TECAB group there was one hospital cardiac death reoperation for bleeding was higher vs in MIDCAB and 2 in PA-CABG and 3-month LAD reintervention was significantly higher 10 vs in MIDCAB and 0 in PA-CABG . There was no difference between MIDCAB and PA-CABG groups. During follow-up symptom-based angiography n 12 demonstrated a good patency of LAD bypass in all groups and 4 patients underwent a no LAD reintervention. At 3 years there was no difference in survival 3-year angina-free survival and reintervention-free survival were significantly lower in TECAB group TECAB 85 12 88 8 MIDCAB 100 98 5 PA-CABG 94 8 100 respectively . Conclusions Our study confirmed that minimally invasive LAD grafting was safe and effective. TECAB is associated with a higher rate of .