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Techniques of Exposure and Stabilization in Off‐Pump Coronary Artery Bypass Graft
Author(s) -
Soltoski Paulo,
Bergsland Jacob,
Salerno Tomas A.,
Karamanoukian Hratch L.,
D'Ancona Giuseppe,
Ricci Marco,
Panos Anthony L.
Publication year - 1985
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1985.tb01314.x
Subject(s) - medicine , cardiology , anastomosis , cardiopulmonary bypass , revascularization , artery , myocardial revascularization , coronary sinus , surgery , myocardial infarction
Recent advances in techniques of coronary artery exposure and myocardial stabilization in off‐pump myocardial revascularization have provided cardiac surgeons with a wide variety of new devices and techniques. Until recently, the main obstacle to performing complete myocardial revascularization without using cardiopulmonary bypass (CPB) has been the technical difficulties of exposing and stabilizing coronary targets, especially those located on the lateral and inferior wall of the heart. The extraordinary cardiac tolerance to nonconstrictive anterior elevation and lateral displacement, however, has allowed the development of new strategies of coronary exposure. These advances, in combination with the development of new techniques of mechanical myocardial stabilization, have impacted on the feasibility and safety with which coronary anastomoses on the beating heart can be constructed. The aim of this article is to describe the technical aspects involved in off‐pump coronary revascularization, focusing primarily on the most recent strategies of cardiac elevation and coronary exposure, the various techniques of myocardial stabilization, and some of the technical details of constructing distal anastomoses on the beating heart.