Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures
Background: This study presents an overview of our technique and the perioperative outcomes for the first 100 patients who underwent minimally invasive endoscopic-assisted off-pump multivessel bypass grafting (endoscopic coronary artery bypass [endo-CAB]) at the Catharina Hospital in Eindhoven....
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic & Cardiovascular Surgery
2025-01-01
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| Series: | Journal of Chest Surgery |
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| _version_ | 1841560947880099840 |
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| author | De Qing Görtzen Fleur Sampon Naomi Timmermans Joost Ter Woorst Ferdi Akca |
| author_facet | De Qing Görtzen Fleur Sampon Naomi Timmermans Joost Ter Woorst Ferdi Akca |
| author_sort | De Qing Görtzen |
| collection | DOAJ |
| description | Background: This study presents an overview of our technique and the perioperative
outcomes for the first 100 patients who underwent minimally invasive endoscopic-assisted
off-pump multivessel bypass grafting (endoscopic coronary artery bypass [endo-CAB])
at the Catharina Hospital in Eindhoven.
Methods: The first 100 patients undergoing multivessel endo-CAB from May 2022 to
March 2024 were included in this retrospective, single-center, observational study (N=100).
The study encompassed both elective and urgent surgical revascularization. In all cases,
endoscopic-assisted harvesting of the internal mammary artery, radial artery, or saphenous
vein was performed, followed by beating-heart anastomoses through a mini-thoracotomy.
Results: A total of 226 distal anastomoses were performed, utilizing 102 left internal
mammary arteries, 80 radial arteries, 30 right internal mammary arteries, and 14 saphenous
veins. On average, each patient had 2.3 anastomoses. A Y graft configuration was employed
in 78 patients, in-situ bilateral internal mammary artery inflow in 19 patients, and a
proximal aortic graft in 3 patients. Four patients underwent concurrent arrhythmia surgery.
Eleven patients received hybrid revascularization. There was 1 conversion to sternotomy
(1%) and 3 instances where cardiopulmonary bypass was required (3%). The median operation
time was 3.3 hours (interquartile range, 3.0–3.7 hours), and the median hospital stay
was 4.0 days (interquartile range, 3–4 days). The in-hospital mortality rate was 1%.
Conclusion: Multivessel off-pump endo-CAB surgery can be safely performed with endoscopic-
assisted conduit harvesting. Combining the benefits of a minimally invasive and
anaortic approach may improve perioperative outcomes for patients requiring surgical
revascularization. Further studies are necessary to establish the role of this technique in
routine coronary surgery. |
| format | Article |
| id | doaj-art-28dae52d78934487b0693742aca075ea |
| institution | Kabale University |
| issn | 2765-1606 2765-1614 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj-art-28dae52d78934487b0693742aca075ea2025-01-03T07:13:15ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142025-01-01581213010.5090/jcs.24.080Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 ProceduresDe Qing Görtzen0https://orcid.org/0009-0001-4934-8249Fleur Sampon1https://orcid.org/0009-0008-9168-9339Naomi Timmermans2https://orcid.org/0009-0002-9734-272XJoost Ter Woorst3https://orcid.org/0000-0003-1886-4045Ferdi Akca4https://orcid.org/0000-0002-1748-3235Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The NetherlandsDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The NetherlandsDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The NetherlandsDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The NetherlandsDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The NetherlandsBackground: This study presents an overview of our technique and the perioperative outcomes for the first 100 patients who underwent minimally invasive endoscopic-assisted off-pump multivessel bypass grafting (endoscopic coronary artery bypass [endo-CAB]) at the Catharina Hospital in Eindhoven. Methods: The first 100 patients undergoing multivessel endo-CAB from May 2022 to March 2024 were included in this retrospective, single-center, observational study (N=100). The study encompassed both elective and urgent surgical revascularization. In all cases, endoscopic-assisted harvesting of the internal mammary artery, radial artery, or saphenous vein was performed, followed by beating-heart anastomoses through a mini-thoracotomy. Results: A total of 226 distal anastomoses were performed, utilizing 102 left internal mammary arteries, 80 radial arteries, 30 right internal mammary arteries, and 14 saphenous veins. On average, each patient had 2.3 anastomoses. A Y graft configuration was employed in 78 patients, in-situ bilateral internal mammary artery inflow in 19 patients, and a proximal aortic graft in 3 patients. Four patients underwent concurrent arrhythmia surgery. Eleven patients received hybrid revascularization. There was 1 conversion to sternotomy (1%) and 3 instances where cardiopulmonary bypass was required (3%). The median operation time was 3.3 hours (interquartile range, 3.0–3.7 hours), and the median hospital stay was 4.0 days (interquartile range, 3–4 days). The in-hospital mortality rate was 1%. Conclusion: Multivessel off-pump endo-CAB surgery can be safely performed with endoscopic- assisted conduit harvesting. Combining the benefits of a minimally invasive and anaortic approach may improve perioperative outcomes for patients requiring surgical revascularization. Further studies are necessary to establish the role of this technique in routine coronary surgery.endoscopic coronary artery bypass graftingoff-pump coronary bypass graftingminimally invasive cardiac surgeryminimally invasive direct coronary artery bypass |
| spellingShingle | De Qing Görtzen Fleur Sampon Naomi Timmermans Joost Ter Woorst Ferdi Akca Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures Journal of Chest Surgery endoscopic coronary artery bypass grafting off-pump coronary bypass grafting minimally invasive cardiac surgery minimally invasive direct coronary artery bypass |
| title | Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures |
| title_full | Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures |
| title_fullStr | Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures |
| title_full_unstemmed | Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures |
| title_short | Endoscopic-Assisted Multivessel Off-Pump Coronary Artery Bypass Grafting: Experience of the First 100 Procedures |
| title_sort | endoscopic assisted multivessel off pump coronary artery bypass grafting experience of the first 100 procedures |
| topic | endoscopic coronary artery bypass grafting off-pump coronary bypass grafting minimally invasive cardiac surgery minimally invasive direct coronary artery bypass |
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