Avtor/Urednik     Klokočovnik, Tomislav
Naslov     Myocardial revascularization without cardiopulmonary bypass through a ministernotomy
Prevedeni naslov     Premostitvena operacija na venčnih arterijah skozi ministernotomijo brez zunajtelesnega krvnega obtoka
Tip     članek
Vir     Endoskopska revija
Vol. in št.     Letnik 12, št. 27
Leto izdaje     2007
Obseg     str. 27-30
ISSN     1318-8941
Jezik     eng
Abstrakt     Background. Although a minimally invasive operative approach has been increasingly used in cardiovascular surgery lately, minimal access off-pump revascularization remains an uncommon procedure.Patients and methods. At this Department, revascularisation of the left anterior descending artery with the left internal mammary artery (LIMA- LAD) performed via a ministernotomy without cardiopulmonary bypass (CPB), was used in two patients with a total LAD occlusion and good left ventricular function.Results. A LIMA-LAD anastomosis without CPB performed via a ministernotomy is a safe, yet technically relatively demanding operative technique. Both our patients had an uneventful postoperative course and were discharged from the hospital four and five days after the operation, respectively. No surgery-related complications were observed within 30 days of surgery. Conclusions. In properly selected patients, a LIMA-LAD off-pump anastomosis performed through a ministernotomy has proved a safe technique with good postoperative results Its advantages include decreased postoperative pain, faster recovery and shorter hospital stay.
Izvleček     Izhodišča. Čeprav je manj invazivna kirurška tehnika že uveljavljena metoda v kardiovaskularni kirurgiji, je minimalni pristop za premostitvene operacije na venčnih arterijah brez uporabe naprave za zunajtelesni krvni obtok (ZKO) še vedno redko uporabljena metoda. Bolniki in metode. Minimalno invazivo metodo za premostitev leve venčne arterije z levo prsno arterijo (LIMA-LAD) na delujočem srcu skozi ministernotomijo smo uporabili pri dveh bolnikih. V obeh primerih je bila indikacija za operativni poseg popolna zapora arterije LAD ob dobri funkciji levega prekata. Rezultati. LIMA-LAD na delujočem srcu skozi ministernotomijo se je izkazala kot varna kirurška metoda, čeprav je za kirurga poseg tehnično nekoliko zahtevnejši. Pri obeh bolnikih je bil pooperativni potek brez zapletov, po četrtem in petem dnevu sta bila odpuščena iz bolnišnice in tudi v 30 dneh po operaciji ni prišlo do zapletov, ki bi bili lahko povezani z operativnim posegom. Zaključki. LIMA-LAD na delujočem srcu skozi ministernotomijo je možno opraviti varno v izbranih primerih z dobrimi pooperativnimi rezultati.
Deskriptorji     MYOCARDIAL REVASCULARIZATION
CORONARY ARTERY BYPASS
SURGERY, MINIMALLY INVASIVE