Bailouts to LIMA Damage for Avoiding Conversion in Minimal Access Coronary Procedures

Thanos Athanasiou; Hutan Ashrafian; Leanne Harling; Roberto P Casula

doi:10.1016/j.athoracsur.2016.02.059

Bailouts to LIMA Damage for Avoiding Conversion in Minimal Access Coronary Procedures

Ann Thorac Surg. 2016 Aug;102(2):e173-6. doi: 10.1016/j.athoracsur.2016.02.059.

Authors

Thanos Athanasiou¹, Hutan Ashrafian², Leanne Harling², Roberto P Casula²

Affiliations

¹ Department of Cardiothoracic Surgery, Imperial College London, London, United Kingdom. Electronic address: t.athanasiou@imperial.ac.uk.
² Department of Cardiothoracic Surgery, Imperial College London, London, United Kingdom.

PMID: 27449460
DOI: 10.1016/j.athoracsur.2016.02.059

Abstract

Minimally invasive and robotic coronary revascularization strategies offer less pain, fewer adverse events, better cosmesis, and speedier recovery. These procedures are vulnerable to left internal mammary artery (LIMA) injury that may require a full sternotomy, which eliminates the benefits of minimally invasive procedures. We present a management protocol to avoid conversion to sternotomy in minimally invasive cases based on the location of the LIMA injury at proximal, mid, and distal locations. By applying axillary bypass, LIMA extension, and repair over a shunt approaches, our protocol can be used as a successful bailout to LIMA damage in minimally invasive coronary cases.

Publication types

Technical Report

MeSH terms

Coronary Artery Disease / surgery*
Humans
Internal Mammary-Coronary Artery Anastomosis / methods*
Mammary Arteries / transplantation*
Minimally Invasive Surgical Procedures / methods*
Robotics / methods*
Sternotomy