J Cardiothorac Vasc Anesth 1997 Aug;11(5):552-555
Department of Cardiothoracic Anesthesia and Surgery, Heart Center of Denton, TX, USA.
OBJECTIVE: To examine the anesthesia implications of minimally invasive thoracoscopically assisted coronary artery bypass (MITACAB) surgery. DESIGN: A combined retrospective and prospective observational report of patients undergoing MITACAB surgery. SETTING: A community heart center. PARTICIPANTS: Patients having MITACAB surgery. INTERVENTIONS: None specifically related to the report. MAIN RESULTS: The MITACAB approach was found to be successful in completing left internal mammary artery (LIMA) to left anterior descending coronary artery (LAD) bypass in 17 of 20 patients. No patient required emergency institution of cardiopulmonary bypass or defibrillation during the procedure. However, 6 of the 17 patients who underwent the MITACAB surgery required transvenous pacing at the time of surgery. None of 17 patients who underwent MITACAB surgery has required additional cardiovascular intervention since the time of surgery. Stroke volume and pulmonary arterial pressures were generally unaffected during performance of the bypass graft. CONCLUSION: MITACAB requires special anesthetic interventions; however, MITACAB appears to be a safe, effective approach to LIMA-to-LAD bypass.