Beating heart myocardial revascularisation with mini-thoracotomy and hybrid approach

Beating heart myocardial revascularisation with mini-thoracotomy and hybrid approach

Many of the coronary artery bypass operations in our Centre are performed with a beating heart, i.e. without activating extracorporeal circulation and without stopping the heart.
Extracorporeal circulation ensures blood flow while the heart and lungs are stopped in order to perform the operation. Although the heart-lung machine allows many procedures to be performed safely, it causes a generalised inflammatory response triggered by the contact of blood with non-organic material in the circuit.
In appropriately selected cases, beating-heart revascularisation procedures are preferred.

Advantages of beating-heart surgery are: fewer renal and pulmonary complications, shorter hospital stays, less postoperative bleeding, greater postoperative cardiac stability.
QThese advantages are amplified when beating-heart surgery is performed with a minimally invasive approach.
Our Centre has a very large case history of aortocoronary bypass surgery using mini-thoracotomy, without the need to open the sternum. These operations are often performed with a hybrid approach, i.e. bypass the main vessels, and subsequent completion with secondary vessel angioplasty, in close collaboration with our haemodynamic colleagues.