Beating heart surgery for coronary stenosis disease at NTUH - Taiwan

The beating heart surgery is a sector that it has a lot of controversy in cardiac surgery. However, I am crazy about this surgery because experience of surgeon and they have performed very professional. I think that I have updated and consolidated much knowledge about this surgery (In Vietnam, we sometimes perform this surgery but not regular because all of Vietnamese surgeon don’t get used to it and they always prefer to CABG with CPB and cardioplegia)
Steps of beating heart surgery for coronary artery disease as follow:
- Supine, ETGA, midline sternotomy
- Harvest LIMA and SVG on the left
-Grafting to coronary arteries by LIMA and SVG. This thing is performed by beating heart or partial CPB (cardiopulmonary bypass)
-If beating heart: grafting LIMA -> LAD (the left anterior descending artery or a branch of left coronary artery) -> PDA (posterior descending artery – a branch of right coronary artery) -> OMs (a branch of circumplex artery).
-If partial CPB:
+ Cannulation via AsAo, SVC and IVC
+ On CPB, cooling to 28 - 300C
+ Grafting LIMA -> LAD (the left anterior descending artery or a branch of left coronary artery) -> PDA (posterior descending artery – a branch of right coronary artery) -> OMs (a branch of circumplex artery).
- Re-warm, de-air, wean off CPB
- Remove canuls
- Haemostasis
- Set drains
- Close wound in layers