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Shigeaki Ohtake
Yoshiki Sawa
Hiroshi Kato
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Asian Cardiovasc Thorac Ann 2001;9:7-9
© 2001 Asia Publishing EXchange Pte Ltd

ORIGINAL CONTRIBUTION

Thoracoscopic Internal Thoracic Artery Harvest: Angiographic Assessment

Nobuaki Hirata, MD, Shigeaki Ohtake, MD, Yoshiki Sawa, MD, Masao Yoshitatsu, MD, Hiroshi Kato, MD1,, Nobukazu Ohkubo, MD1,, Hikaru Matsuda, MD

First Department of Surgery Osaka University Medical School Osaka, Japan
1 Division of Cardiovascular Surgery Toyonaka Municipal Hospital Osaka, Japan
For reprint information contact: Nobuaki Hirata, MD Tel: 81 797 87 1161 Fax: 81 797 87 5624 Division of Cardiovascular Surgery, Takarazuka Municipal Hospital, 4-5-1 Kohama, Takarazuka, Hyogo 665-0827, Japan.
Minimally invasive direct coronary artery bypass grafting was carried out in 10 patients. The left internal thoracic artery was mobilized under direct vision in the first 5 and by thoracoscopy in the next 5. Postoperative arteriography confirmed the advantage of thoracoscopic arterial harvest. The length of the thoracoscopically harvested artery was 10 ± 2 cm compared to 6 ± 1 cm for grafts harvested under direct vision (p < 0.05). The anastomotic angle between the internal thoracic artery and the left anterior descending coronary artery was 43° ± 4° for thoracoscopically harvested grafts versus 62° ± 5° for the direct vision method (p < 0.05). One anastomotic complication (occlusion) was found in a patient who had arterial harvest under direct vision. Internal thoracic artery harvested by thoracoscopy diverges from the chest wall and runs directly to the anastomotic site. Such a conduit harvested by direct vision runs along the chest wall until near the anastomotic site, which might increase the risk of anastomotic complications.






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