There is a tendency in all fields of surgery to move towards less invasive surgical techniques in recent years. The end point of this study was to analyse the possibility of myocardial revascularization through a minimum left thoracotomy approach. From September 1995 till March 1996 we operated on 19 patients that had isolated lesion of interventricular anterior artery (IAA) and/or diagonal. The anastomoses were made by a left minor thoracotomy, opening the pleura at the 4º intercostal space. Through this incision we dissected the thoracic internal artery with ligation of only few branches. The anastomoses were performed without extracorporeal circulation, with a simple interruption of coronary blood flow. At the second postoperative day we studied the patients with angiography and transthoracic echo-Doppler, to verify patency and flow. All patients had uneventful recovery without major complications. Angiography was made in 16 out of 19 and showed patency in 13. The 3 patients with graft occlusion were reoperated on without complications. The presented technique did not involve ligation of the intercostal branches, however these branches were not demonstrated by angiography. Transthoracic Doppler showed good relationship with angiographic findings. The initial results with this technique suggest that we can have another option of minimum invasive myocardial revascularization for selected patients.
Myocardial revascularization; Surgery minimally invasive; Mammary arteries; Coronary vessels; Myocardial revascularization