[Coronary surgery with minimum access and cardiopulmonary bypass]

From October 1997 to March 1998 we operatedon seven patients with minimal incision, cardiopulmonaryby-pass with femoral cannulation and antegradeblood cardioplegic arrest using the «endoclamp» (Heartport Inc.). The seven patients withisolated severe lesions of the left anterior descendingunderwent a left internal thoracic artery graftunder direct vision. Three had saphenous vein coronarybypass grafts performed to the diagonal (2)and obtuse marginal branches of the left coronaryartery.The median cardiopulmonary bypass durationwas 75 minutes (30-230) and the aortic occlusiontime was 33 minutes (10-117). No major complicationsoccurred and only two minor ones were noted.The median intensive care unit stay was 2 days(1 to 4) and the total hospital stay was 6.5 days (3to 13). All the patients are in NYHA FC I, withouttreatment and a follow up of 3 to 6 months afterthe surgery.With this method of myocardial revascularizationwith minimal incision and cardiopulmonary bypassthe sternotomy-related complications can be avoided,the intensive care unit and hospital stay canbe reduced with better convalescence for the selectedpatients. We believe that this technique is a validoption for an increasing number of patients.