Coronary bypass grafting using MICSCAB technique with parallel artificial circulation from mini access

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BACKGROUND: Today, minimally invasive coronary surgery is not only a good alternative to classical sternotomy, but also represents a separate developing area of cardiac surgery with the development of more and more low-traumatic techniques, such as minimally invasive direct coronary artery bypass and minimally invasive direct coronary artery bypass (MICSCAB).

CLINICAL CASE DESCRIPTION: The advantages and disadvantages of these techniques are widely discussed in modern literature, and their practical application is ambiguous. This article describes a clinical case of successful coronary artery bypass grafting using the MICSCAB technique in a patient with a long history of coronary artery disease and a complex multivessel lesion.

CONCLUSION: The presented clinical case proves the advantage of MICSCAB technique in comparison with traditional coronary bypass surgery.

作者简介

Ulugbek Teshaev

Republican Specialized Scientific and Practical Medical Center for Surgery named after V. Vakhidov

编辑信件的主要联系方式.
Email: ulug_leo@mail.ru
乌兹别克斯坦, 1, Navoi street, 200118, Bukhara

Rustam Yarbekov

Republican Specialized Scientific and Practical Medical Center for Surgery named after V. Vakhidov

Email: yarbekov@mail.ru
ORCID iD: 0000-0001-5918-8181

MD, Dr. Sci. (Med.)

乌兹别克斯坦, Tashkent

Sanzhar Omonov

Republican Specialized Scientific and Practical Medical Center for Surgery named after V. Vakhidov

Email: sanjikomon@mail.ru

MD, Cand. Sci. (Med.)

乌兹别克斯坦, Tashkent

Maksud Muradov

Republican Specialized Scientific and Practical Medical Center for Surgery named after V. Vakhidov

Email: mmmaksud1986@gmail.com
ORCID iD: 0000-0002-7599-9803

MD, Cand. Sci. (Med.)

乌兹别克斯坦, Tashkent

Gulnora Nagaeva

Multidisciplinary Medical Center “EZGU NIYAT”

Email: nagaeva.gulnora@mail.ru
ORCID iD: 0000-0001-8643-0201

MD, Cand. Sci. (Med.)

乌兹别克斯坦, Tashkent

参考

  1. Jeremias A, Kaul S, Rosengart TK, et al. The impact of revascularization on mortality in patients with nonacute coronary artery disease. Am J Med. 2009;122(2):152–161. doi: 10.1016/j.amjmed.2008.07.027
  2. Shabaev IF, Tarasov RS, Kozyrin KA. In-hospital results of minimally invasive off-pump coronary artery bypass grafting. Complex Issues of Cardiovascular Diseases. 2019;8(2):58–67. (In Russ). doi: 10.17802/2306-1278-2019-8-2-58-67
  3. Niclauss L. Techniques and standards in intraoperative graft verification transit time flow measurement after coronary artery by passgraft surgery: a critical review. Eur J Cardiothorac Surg. 2017;51(1):26–33. doi: 10.1093/ejcts/ezw203
  4. Zenkov AA. Life quality analysis on the application of different methods of surgical myocardial revascularization: prospective randomized trial MICSREVS. Vestnik of Vitebsk State Medical University. 2018;(1):68–80. (In Russ). doi: 10.22263/2312-4156.2018.1.68
  5. Lamy A, Devereaux PJ, Prabhakaran D, et al. Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year. N Eng J Med. 2013;368(13):1179–1188. doi: 10.1056/NEJMoa1301228
  6. Sidorov RV, Bazilevich AV, Katkov AA. Low invasive coronary surgery: overview of coronary heart disease modern surgical treatment techniques. Bulletin of Pirogov National Medical & Surgical Center. 2021;16(3):84–88. (In Russ). doi: 10.25881/20728255_2021_16_3_84
  7. Neumann F-J, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization the task force on myocardial revascularization of the European society of cardiology (ESC) and the European association for cardio-thoracic surgery (EACTS) developed with the special contribution of the European association of percutaneous cardiovascular interventions (EAPCI). Russian Journal of Cardiology. 2019;24(8):151–226. (In Russ). doi: 10.15829/1560-4071-2019-8-151-226
  8. Cao C, Indraratna P, Doyle M, et al. A systematic review on robotic coronary artery bypass graft surgery. Ann Cardiothorac Surg. 2016;5(6):530–543. doi: 10.21037/acs.2016.11.08

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2. Fig. 1. Findings of coronary angiography of patient M. dated October 18, 2021: (a) stenoses are visualized in the anterior interventricular branch, the circumflex branch, and intermedial artery; (b) visualization of the anterior interventricular branch; (c) visualization of the circumflex branch and the intermedial artery; (d) right coronary artery, left oblique view; (e) right coronary artery, cranial view.

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3. Fig. 2. Stages of surgical cardiac intervention: (а) clamping of the ascending aorta; (b) imposition of proximal anastomoses; (c) flowmetry of the left internal thoracic artery-anterior interventricular branch shunt; (d) final view. Here: RA, right atrium; 5rib, fifth rib; LV, left ventricle; LIMA, left intramammary artery.

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