Thoracoscopic Internal Thoracic Artery Harvest: Angiographic Assessment

Abstract

Minimally invasive direct coronary artery bypass grafting was carried out in 10 patients. The left internal thoracic artery was mobilized under direct vision in the first 5 and by thoracoscopy in the next 5. Postoperative arteriography confirmed the advantage of thoracoscopic arterial harvest. The length of the thoracoscopically harvested artery was 10 ± 2 cm compared to 6 ± 1 cm for grafts harvested under direct vision (p < 0.05). The anastomotic angle between the internal thoracic artery and the left anterior descending coronary artery was 43° ± 4° for thoracoscopically harvested grafts versus 62° ± 5° for the direct vision method (p < 0.05). One anastomotic complication (occlusion) was found in a patient who had arterial harvest under direct vision. Internal thoracic artery harvested by thoracoscopy diverges from the chest wall and runs directly to the anastomotic site. Such a conduit harvested by direct vision runs along the chest wall until near the anastomotic site, which might increase the risk of anastomotic complications.