Port-Access coronary artery bypass grafting: technical strategies for multivessel complete revascularization

Complete coronary artery revascularization results in improved symptom-free survival. Standard cardiac revascularization uses cardiac arrest for microvascular anastomoses. The Port-Access system allows multiple coronary anastomoses in an arrested blood-free field. The technique of Port-Access coronary artery bypass grafting has evolved from one based on internal mammary artery inflow to one based on aortic inflow. Proximal aortic anastomoses enables the surgeon to revascularize more targets more reliably. Procedural time is shortened with the use of these new techniques and familiarity with the EndoCPB endovascular cardiopulmonary bypass system. Port-Access revascularization results in short-term acceptable results, patient satisfaction, and decreased hospitalization.