Coronary surgery with minimum access and cardiopulmonary bypass]

From October 1997 to March 1998 we operated on seven patients with minimal incision, cardiopulmonary by-pass with femoral cannulation and antegrade blood cardioplegic arrest using the "endoclamp" (Heartport Inc.). The seven patients with isolated severe lesions of the left anterior descending underwent a left internal thoracic artery graft under direct vision. Three had saphenous vein coronary bypass grafts performed to the diagonal (2) and obtuse marginal branches of the left coronary artery. The median cardiopulmonary bypass duration was 75 minutes (30-230) and the aortic occlusion time was 33 minutes (10-117). No major complications occurred and only two minor ones were noted. The median intensive care unit stay was 2 days (1 to 4) and the total hospital stay was 6.5 days (3 to 13). All the patients are in NYHA FC I, without treatment and a follow up of 3 to 6 months after the surgery. With this method of myocardial revascularization with minimal incision and cardiopulmonary bypass the sternotomy-related complications can be avoided, the intensive care unit and hospital stay can be reduced with better convalescence for the selected patients. We believe that this technique is a valid option for an increasing number of patients.