Vol. 25 No. 2 (2021)
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Microscope-assisted coronary artery bypass grafting: features of creating side-to-side anastomosis

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  • A.N. Semchenko,
  • A.D. Makarov
A.N. Semchenko
Federal Center for Cardiovascular Surgery of Healthcare Ministry of the Russian Federation, Khabarovsk
Bio
A.D. Makarov
Federal Center for Cardiovascular Surgery of Healthcare Ministry of the Russian Federation, Khabarovsk
DOI: https://doi.org/10.21688/1681-3472-2021-2-102-107

Published 2021-06-28

Keywords

  • coronary artery bypass surgery,
  • microsurgery,
  • operating microscope,
  • sequential bypass grafting

How to Cite

Semchenko, A., & Makarov, A. (2021). Microscope-assisted coronary artery bypass grafting: features of creating side-to-side anastomosis. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 25(2), 102–107. https://doi.org/10.21688/1681-3472-2021-2-102-107

Copyright (c) 2021 Semchenko A.N., Makarov A.D.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

This paper describes the step-by-step technique of microscope-assisted creation of side-to-side anastomosis for sequential coronary bypass grafting and the simplified mastering of microscope-assisted coronary artery bypass grafting. Based on our experience, we describe the optimal magnification of the operating microscope, the preferred dimensions of the suture material and the types of microsurgical instruments. We describe in detail the technique and features of microscope-assisted creation of side-to-side anastomosis. In conclusion, we provide brief information about the global practice of microscope-assisted coronary bypass grafting and discuss the advantages of using an operating microscope and microsurgical technologies for creating side-to-side coronary anastomoses.

Received 12 October 2020. Revised 14 November 2020. Accepted 17 November 2020.

Funding: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

PDF (Русский)

References

  1. Акчурин Р.С., Ширяев А.А. Микрохирургия коронарных артерий: Руководство. М.: ГЭОТАР-Медиа, 2012. 144 с. [Akchurin R.S., Shiryaev A.A. Microsurgery of the coronary arteries; guide. Moscow: GEOTAR-Media Publ.; 2012. 144 p. (In Russ.)]
  2. Ширяев А.А. Микрохирургическая техника в коронарной хирургии. Кардиология. 2005;45(3):58. [Shiryaev AA. Microvascular technique in coronary surgery. Kardiologiya = Cardiology. 2005;45(3):58. (In Russ.)]
  3. Семченко А.Н. Микрохирургическая техника в коронарной хирургии: возможности, перспективы и ограничения. Хирургия. Журнал им. Н.И. Пирогова. 2019;(6):80-87. [Semchenko A.N. Microsurgical technique in coronary bypass surgery: possibilities, perspectives and limitations. Khirurgiya. Zhurnal im. N.I. Pirogova = Pirogov Journal of Surgery. 2019;(6):80-87. (In Russ.)] https://doi.org/10.17116/hirurgia201906180
  4. Альсов С.А., Цирихов В.Р., Сирота Д.А., Хван Д.С., Ляшенко М.М., Жульков М.О., Чернявский А.М. Микрохирургическое коронарное шунтирование. Особенности работы на операционном микроскопе. Патология кровообращения и кардиохирургия. 2020;24(2):124-128. [Alsov S.A., Tsirikhov V.R., Sirota D.A., Khvan D.S., Lyashenko M.M., Zhulkov M.O., Chernyavskiy A.M. Coronary-artery bypass surgery using an operating microscope. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2020;24(2):124-128. (In Russ.)] http://dx.doi.org/10.21688/1681-3472-2020-2-124-128
  5. Semchenko A., Makarov A., Karpov I., Zharenkov M. Microscope-assisted coronary artery bypass grafting: technique and results. Braz J Cardiovasc Surg. 2020;35(5):815-820. PMID: 33118747; PMCID: PMC7598973. https://doi.org/10.21470/1678-9741-2019-0416
  6. Catapano J., Zuker R., Honjo O., Borschel G. Microvascular coronary artery repair and grafting in infancy and early childhood. Operative Techniques in Thoracic and Cardiovasculary Surgery. 2015;20(2):148-161. https://doi.org/10.1053/j.optechstcvs.2015.11.001
  7. Grow J.B. Sr., Brantigan C.O. The diamond anastomosis: a technique for creating a right-angle side-to-side vascular anastomosis. J Thorac Cardiovasc Surg. 1975;69(2):188-189. PMID: 1089845.
  8. Семченко А.Н., Галяутдинов Д.М., Васильев В.П., Бондарь В.Ю. Секвенциальное шунтирование в коронарной хирургии (обзор литературы). Сибирский медицинский журнал (г. Томск). 2012;27(4):13-19. [Semchenko A.N., Galiautdinov D.M., Vasilev V.P., Bondar V.Yu. Sequential bypass grafting in coronary artery surgery (review). The Siberian Medical Journal. 2012;27(4):13-19. (In Russ.)]
  9. Green G.E., Stertzer S.H., Reppert E.H. Coronary arterial bypass grafts. Ann Thorac Surg. 1968;5(5):443-450. PMID: 5647933. https://doi.org/10.1016/s0003-4975(10)66377-1
  10. Семченко А.Н., Кошкин И.И. 50 лет первой операции маммарокоронарного шунтирования с применением микрохирургической техники и операционного микроскопа в клинике (Джордж Грин, 1968). Патология кровообращения и кардиохирургия. 2018;22(3):86-94. [Semchenko A.N., Koshkin I.I. 50 years of the first mammary-coronary bypass grafting using microsurgical techniques and operating microscope in human (George E. Green, 1968). Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2018;22(3):86-94. (In Russ.).] http://dx.doi.org/10.21688/1681-3472-2018-3-86-94
  11. Loisance D. Aorto-coronary venous bypass. The value of microsurgical techniques. Nouv Presse Med. 1979;8(29):2413-2415. PMID: 386260.
  12. Jairaj P.S., O’Brien B.M., Richardson J.P., Clarebrough J.K., Bennett R.C. The experimental application of microsurgical techniques to internal mammary to coronary artery anastomosis. Aust N Z J Surg. 1972;41(4):379-383. PMID: 4502777. https://doi.org/10.1111/j.1445-2197.1969.tb06552.x
  13. Katsumoto K. Clinical experience of coronary artery bypass grafting using surgical microscope. Kyobu Geka. 1996;49(3):182-186. PMID: 8709420.
  14. Spagnolo S., Barbato L., Scalise F., Grasso M.A., Spagnolo P. A comparison between microsurgery and standard coronary bypass technique of long term patency rates of Saphenous vein grafts. J Invasive Noninvasive Cardiol. 2018;1(3):6-11.
  15. Акчурин Р.С., Ширяев А.А., Галяутдинов Д.М., Васильев В.П., Доценко Ю.В., Власова Э.Е., Черкашин Д.И. Эффективность коронарной хирургии: результаты 20-летнего наблюдения. Кардиология и сердечно-сосудистая хирургия. 2014;7(1):10-14. [Аkchurin R.S., Shiryaev А.А., Galyautdinov D.M., Vasilev V.P., Dotsenko Yu.V., Vlasova E.E., Cherkashin D.I. Effectiveness of coronary surgery: results of 20 years observation. Kardiologiya i serdechno-sosudistaya khirurgiya = Russian Journal of Cardiology and Cardiovascular Surgery. 2014;7(1):10-14. (In Russ.)]
  16. Альсов С.А., Осипов Д.Е., Акчурин Р.С., Ширяев А.А., Сирота Д.А., Хван Д.С., Чернявский А.М., Цирихов В.Р. Микрохирургия коронарных артерий с использованием операционного микроскопа. Хирургия. Журнал им. Н.И. Пирогова. 2019;(1):60-64. [Alsov S.A., Osipov D.E., Akchurin R.S., Shiryaev A.A., Sirota D.A., Khvan D.S., Chernyavskiy A.M., Tsirikhov V.R. Microsurgery of coronary arteries using an operating microscope. Khirurgiya. Zhurnal im. N.I. Pirogova = Pirogov Journal of Surgery. 2019;(1):60-64. (In Russ.)] https://doi.org/10.17116/hirurgia201901160
  17. Лысенко А.В., Салагаев Г.И., Леднев П.В., Белов Ю.В. Госпитальные результаты коронарного шунтирования с использованием операционного микроскопа. Хирургия. Журнал им. Н.И. Пирогова. 2019;(6):5-10. [Lysenko A.V., Salagaev G.I., Lednev P.V., Belov Yu.V. The results of coronary artery bypass grafting by using of surgical microscope. Khirurgiya. Zhurnal im. N.I. Pirogova = Pirogov Journal of Surgery. 2019;(6):5-10. (In Russ.)] https://doi.org/10.17116/hirurgia20190615
  18. Flemma R.J., Johnson W.D., Lepley D. Jr. Triple aorto-coronary vein bypass as treatment for coronary insufficiency. Arch Surg. 1971;103(1):82-83. PMID: 5088438. https://doi.org/10.1001/archsurg.1971.01350070108026
  19. Ji Q., Xia L., Shi Y., Ma R., Shen J., Lai H., Ding W., Wang C. Sequential grafting of in situ skeletonized left internal mammary artery to the left coronary system. Int Heart J. 2018;59(4):727-735. PMID: 29794393. https://doi.org/10.1536/ihj.17-494
  20. Christenson J.T., Schmuziger M. How serious is a proximal occlusion of a posterolateral sequential bypass? Tex Heart Inst J. 1996;23(3):201-206. PMID: 8885102; PMCID: PMC325347.