Vassilios Gulielmos, Michael Knaut, Florian M. Wagner, Stephan Schüler

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Presentation transcript:

Minimally Invasive Surgical Technique for the Treatment of Multivessel Coronary Artery Disease Vassilios Gulielmos, Michael Knaut, Florian M. Wagner, Stephan Schüler The Annals of Thoracic Surgery Volume 65, Issue 5, Pages 1331-1334 (May 1998) DOI: 10.1016/S0003-4975(98)00159-3

Fig. 1 A 6- to 8-cm left lateral chest incision was made at the level of the third intercostal space. The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)

Fig. 2 Through the chest incision, the central part of the heart can be reached and arterial cannulation (A) of the ascending aorta and venous cannulation (B) of the right atrium are feasible. The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)

Fig. 3 Vein grafts can be applied to all coronary arteries, including the right coronary artery. The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)

Fig. 4 Left internal mammary artery bypass graft to the left anterior descending artery (A), vein graft to a diagonal branch of the left anterior descending artery (B), and vein graft to a marginal branch of the left circumflex artery (C). The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)

Fig. 5 In 1 patient, both internal mammary arteries were harvested. The left internal mammary artery was attached to the left anterior descending artery (A). The right internal mammary artery was attached end-to-side to the left internal mammary artery as a T graft (B). The right internal mammary artery was attached to the intermediate branch of the left circumflex artery (C). The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)

Fig. 6 The proximal ends of the vein grafts (A and B) were attached end-to-side to the ascending aorta. The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)

Fig. 7 The closed chest incision after minimally invasive operation for triple-vessel coronary artery disease. The Annals of Thoracic Surgery 1998 65, 1331-1334DOI: (10.1016/S0003-4975(98)00159-3)