Cardiopulmonary bypass for a coronary artery bypass graft patient with heterozygous protein C deficiency and protein S deficiency.

Cardiopulmonary bypass (CPB) poses great risks for hypercoagulable patients and requires management techniques to ensure an optimal outcome free from thrombotic events. This case report reviews perfusion management techniques that may contribute to a safer CPB experience for a patient deficient in both protein C and protein S. A patient with heterozygous protein C deficiency is at increased risk of thrombosis, especially in the venous circulation.

Reduced incidence of atrial fibrillation with minimally invasive direct coronary artery bypass.

Background: Atrial fibrillation (AF) is a frequent complication after coronary artery bypass graft (CABG) surgery. The purpose of this study was to determine the incidence of postoperative AF after minimally invasive direct coronary artery bypass (MIDCAB) in comparison with CABG.

Methods: Between November 1995 and May 1997, 96 MIDCAB procedures were performed.

Morbidity, cost, and six-month outcome of minimally invasive direct coronary artery bypass grafting.

Background: Minimally invasive direct coronary artery bypass grafting (MIDCABG) promises to reduce the morbidity of coronary bypass, but this has not been proved.

Methods: This retrospective study compares the morbidity, mortality, cost, and 6-month outcome of patients less than 80 years old undergoing elective left internal mammary artery to left anterior descending artery bypass grafting via MIDCABG (n = 60) or sternotomy (n = 55) between January 1995 and December 1996. There were no differences between the groups in mean age, sex distribution, or preoperative risk level.

A model that predicts morbidity and mortality after coronary artery bypass graft surgery.

Objectives: This study was performed to develop a method for identifying patients at increased risk for morbidity or mortality after coronary artery bypass graft surgery.

Background: Postoperative morbidity is more common than mortality and is important because of its relation to cost.

Methods: Univariate and forward stepwise logistic regression analysis was used to retrospectively analyze a group of 1,567 consecutive patients who underwent bypass surgery between July 1991 and December 1992.

"Keyhole" coronary artery bypass surgery.

Objective: The objective of this study was to identify the utility of "keyhole" thoracotomy approaches to single vessel coronary artery bypass surgery.

Summary Background Data: Although minimally invasive surgery is efficacious in a wide variety of surgical disciplines, it has been slow to emerge in cardiac surgery. Among 49 selected patients, the authors have used a left anterior keyhole thoracotomy (6 cm in length) combined with complete dissection of the eternal mammary artery (IMA) pedicle under thoracoscopic guidance or directly through the keyhole incision to accomplish IMA coronary artery bypass grafting (CABG) to the left anterior descending (LAD) coronary artery circulation or to the right coronary artery (RCA).