We were scheduled to do this next week. Our first MIS CABG (mine too haha) in Sunway Velocity. However, an unfortunate patient who discovered he had severe 3VD during angio was found to be a good candidate by Prof Zamrin. Hence a semi-e CABG with the MIS ( minimally invasive) approach was chosen. It has been around for a number of years - but technique needs patient to fullfill a number of criteria. At the same time, it needs high skillful surgeon to do it as there are a different number of steps which are totally different from the conventional CABG.
For anaesthetist, the number one difference is the incorporation of double lumen tube instead of the normal ETT. The surgeon needs one of the lungs to be deflated during the arterial graft harvesting. That poses a great challenge to ensure it is perfect during the op. The second would be the usage of TEE to visualise the femoral cannula which the tip should pass the RA into the SVC. Kalau tak reti pakai TEE mmg masaklah haha
All the other steps lebih kurang- ada surgeon will do it fully off pump but most would do it on pump or a combination of both. The equipments needed can be very expensive so there are pros and cons of each technique.
Alhamdulillah, our first MIS CABG went well abd I am thankful that with the good teamwork we had, it made the long hours effort worth it. I am very happy with this milestone as wherever I go in my work journey, Ive always started something different from the rest.
To 2024 and beyond!!
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