A minimally invasive alternative approach for reoperative grafting of the right coronary artery

Reginald Abraham, Marco Ricci, Tomas Salerno, Paul Kerr

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Target vessel revascularization on a beating heart via a mini subxiphoid incision, not only eliminates the hazards of sternal reentry, but also avoids the detrimental systemic effects of extracorporeal circulation. Aim: The goal of the study was to develop and describe a safe and effective method to revascularize the right coronary artery in reoperative cases, using beating heart and minimally invasive techniques in lieu of the RGEA. Methods: There were three men and four women with a mean age of 69 years; four were second time reoperations and three third time reoperations. Through a subxiphoid approach, a lower ministernotomy is performed. Once the coronary target is established, a Rultract retractor is used to gently elevate the right half of the sternum to take down the RITA. A mechanical stabilizer was used to provide stabilization for distal anastamoses. Flow was measured in all the grafts with the Medi-Stim before and after protamine administration. Results: Patient Procedure Conduit Flow Measurement 58 y/o male 3rd time redo Radial > PDA 25 cc/min 83 y/o female 2nd time redo RITA > RCA 35 cc/min 73 y/o female 2nd time redo SVG > PLA 30 cc/min 74 y/o female 3rd time redo SVG > PLA 25 cc/min 63 y/o female 2nd time redo Radial > RCA 55 cc/min 59 y/o male 2nd time redo angioplasty to circumflex SVG > PDA 40 cc/min 75 y/o male. 3rd time redo stent to SVG on circumflex SVG > RCA 50 cc/min Conclusion: We believe that this technique provides another effective approach to the patient who requires reoperative coronary revascularization of the RCA.

Original languageEnglish (US)
Pages (from-to)289-291
Number of pages3
JournalJournal of cardiac surgery
Volume17
Issue number4
StatePublished - Jul 1 2001
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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