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In the early days of cardiac surgery, but also in the following four decades, median sternotomy and cardiopulmonary bypass were nearly always included in cardiac surgical procedures. Less invasive surgical techniques were developed with the aim of reducing perioperative trauma without compromising the surgical result, and things became more complex for cardiac surgeons. They now often had to consider the surgical access of choice and whether cardiopulmonary bypass should be used or not.
Since the mid 1990s, not only have several novel minimally invasive surgical techniques been presented, but also further refinements have been recommended from time to time.
This work comes to fill a gap in the field of coronary artery bypass grafting and conduit harvesting in cardiac surgery, by gathering the mature version of such new, less invasive techniques combining safety, effectiveness, simplicity, sometimes even reducing procedural costs and that always for the patient's and for the surgeon's sake.
List of contents
A historical review: From standardized coronary bypass grafting to off-pump surgery.- What do we know about OPCAB surgery On-pump versus off-pump.- Systemic Inflammatory Response After Cardiac Surgery: Is extracorporeal circulation the main culprit?.- 2: OPCAB.- Different stabilizer concepts and exposure techniques for off-pump coronary artery bypass surgery.- Adjunct tools in OPCAB surgery.- Monitoring and devices for hemodynamic assessment during OPCAB.- Anesthetic management.- Atrial stimulation during OPCAB. A simple maneuver to maintain stable hemodynamics during OPCAB.- Developing an OPCAB program.- Surgical techniques for off-pump coronary artery bypass grafting.- OPCAB for multiple arterial revascularization.- 3: MIDCAB.- MIDCAB - anesthesia management.- MIDCAB - small access bypass surgery.- Minimally invasive direct coronary artery bypass grafting via partial inferior sternotomy.- Robotic-enhanced MIDCAB.- Off-pump totally endoscopic coronary artery bypass grafting.- 4: Minimally Invasive Conduit Harvesting.- Minimally invasive vein harvesting.- Minimally invasive vein harvesting - video-assisted vein harvesting.- Minimally invasive video-assisted endoscopic vein harvesting.- Advances in minimally invasive harvesting of the radial artery for coronary bypass grafting.- Endoscopie radial artery harvest.
About the author
Vassilios Gulielmos, Geniki Kliniki, Thessaloniki, Greece
Summary
In the early days of cardiac surgery, but also in the following four decades, median sternotomy and cardiopulmonary bypass were nearly always included in cardiac surgical procedures. Less invasive surgical techniques were developed with the aim of reducing perioperative trauma without compromising the surgical result, and things became more complex for cardiac surgeons. They now often had to consider the surgical access of choice and whether cardiopulmonary bypass should be used or not.
Since the mid 1990s, not only have several novel minimally invasive surgical techniques been presented, but also further refinements have been recommended from time to time.
This work comes to fill a gap in the field of coronary artery bypass grafting and conduit harvesting in cardiac surgery, by gathering the mature version of such new, less invasive techniques combining safety, effectiveness, simplicity, sometimes even reducing procedural costs and that always for the patient’s and for the surgeon’s sake.
