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British Medical Bulletin 59:261-268 (2001)
© 2001 Oxford University Press

Minimally invasive therapy and robotics

Treatments in ischaemic heart disease

T J Spyt* and A C De Souza{dagger}

*Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
{dagger}Royal Brompton Hospital, London, UK

The first 150 words of the full text of this article appear below.


   Introduction
 
Considerable progress in the surgical management of coronary artery disease over the last several years has undoubtedly been influenced by developments in the technology of extracorporeal circulation and refinements in myocardial protection during surgery1Go. This was associated with improvements in surgical technique, the introduction of quality suturing material, recognition of the importance of the choice of conduit and more appropriate selection of patients for intervention.

The introduction of safe cardioplegic arrest enabled immobilisation of the heart for a period of time necessary for the construction of multiple bypasses. The majority of cardiac surgeons adopted this strategy as safe for the patient and comfortable for the operator.

However, effective bypass grafting can be performed without the use of cardiopulmonary bypass. A small group of surgeons continued to follow the pioneering work of Kolesow who, in 1964, bypassed the anterior descending artery on the beating heart2Go,3Go. Between 1995 and 1997, . . . [Full Text of this Article]


   Minimally invasive direct coronary artery bypass
 

   Off pump CABG (OPCAB)
 

   Coronary artery bypass grafting through limited access with the use of extracorporeal circulation (port access CABG)
 

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