Coronary Artery Bypass Graft (CABG) - Desun Hospital Health Insight

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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery History of Heart Surgery

[object Object],[object Object],[object Object],[object Object],[object Object],BJ Harlan, et al; Manual of Cardiac Surgery Indications for Surgery

[object Object],[object Object],[object Object],[object Object],Adapted from BJ Harlan, et al; Manual of Cardiac Surgery Conventional CABG

[object Object],[object Object],[object Object],[object Object],[object Object],BJ Harlan, et al; Manual of Cardiac Surgery Conduits Used for Bypass

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GP Gravlee, et al; Cardiopulmonary Bypass: Principles and Practice Conventional CABG Procedure

[object Object],[object Object],[object Object],BJ Harlan, et al; Manual of Cardiac Surgery Conventional CABG Procedure

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BJ Harlan, et al; Manual of Cardiac Surgery, WebMD.com, American College of Cardiology Foundation Conventional CABG

[object Object],[object Object],[object Object],[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Minimally Invasive Direct CABG

[object Object],[object Object],[object Object],[object Object],[object Object],TA Salerno, et al. Beating Heart Coronary Artery Surgery Advantages of MIDCAB Over CABG MIDCAB CABG Full sternotomy No Yes CPB No Yes Operating time 2-3 hrs 3-6 hrs Recovery time 1-2 weeks 3-6 months Effectiveness 90% 90% Incision length 10 cm 30 cm

Small incisions for video-assisted LIMA harvest Thoracotomy incision (~10 cm) RG Cohen, et al; Minimally Invasive Cardiac Surgery MIDCAB Procedure

[object Object],[object Object],[object Object],[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery MIDCAB Procedure

[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Completed graft MIDCAB Procedure

[object Object],[object Object],[object Object],Clinical Results Using MIDCAB Mehran R, et al; Circulation In-hospital MACE 1% Procedure time 132±20 minutes Time to extubation 6±3 hours Hospital stay 2.1±1.9 days Mortality (one year) 1% MACE (one year) 6%

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Drawbacks of MIDCAB

[object Object],[object Object],[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Port-Access CABG

[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Port-Access CABG

[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Port-Access CABG

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],RG Cohen, et al; Minimally Invasive Cardiac Surgery Port-Access CABG

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],New England Journal of Medicine Stent or Surgery?

[object Object],[object Object],The Lancet, Journal of the American College of Cardiology Stent or Surgery? PCI and Stenting n=480 CABG n=487 Mortality at 1 year 2.5% 0.8% Need for additional PCI 13% 4.8% Need for additional CABG 9% 1% Overall adverse effects 22.1% 12.2%

[object Object],[object Object],Journal of the American College of Cardiology Stent or Surgery? Costs Medical Status After 1 Year In patients with 3-vessel disease All Patients Enrolled PTCR n=225 CABG n=225 MACE 30 days 3.6% 12.3% Death 30 days 0.9% 5.7% Survival 1 year 96.9% 92.5% Freedom for MI 97.7% 93.4% Need for revascularization 16.8% 4.8%

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Current Controlled Trials in Cardiovascular Medicine Summary: Stent or Surgery?

[object Object],[object Object],[object Object],[object Object],[object Object],In The Future...

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Questions???

Coronary Artery Bypass Graft (CABG) - Desun Hospital Health Insight

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Coronary Artery Bypass Graft (CABG) - Desun Hospital Health Insight

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