ABSTRACT 56

AMBULATORY CORONARY SURGERY  CLINICAL EXPERIENCE

Guida M.  * Torrealba C., ** Rivera J., ** Apruzzese I., **Lugo A., ** Hidalgo P., *** Benetti F.
*Servicio  de Cirugía Cardiovascular del Centro Médico Guerra Méndez. Valencia.Venezuela
**Servicio de Cirugía Cardiovascular del Hospital Coromoto de Maracaibo.Maracaibo. Venezuela
***Benetti Foundation

From October 1999 to September 2000, five male patients were operated on through the Xiphoid Lower Sternotomy (Benetti Technique) in ambulatory fashion. Aged ranked from 45 to 78 year old, X= 62. All of them in Class III Canadian Association, hypertensive and dislipidemy; 3 were diabetic Type II.  They were studied with Coronariography, with damage of the Anterior Descendent Artery (ADA), in more than 95% in all of them. In two failed angioplasty had been performed, one of them with Stent reestenosis in ADA before our surgery. All the patients received Left Internal Mammalian bypass in ADA by mean xiphoid approach and 5 to 9 cm length cut, using different retractors : MIDCAB in 3 and ULTIMA in 2 patients. Mechanical stabilizer in 4 (CTS GUIDANT) and 1 with CTS VORTEX. Three patients walked inside the operating room and were discharged within next 24 Hs; 2 were released at 30 and 36 hours later because of large housing distance from the city. Mean follow up of 7 months, with rank between 1 and 12; symptoms free and watching with talio 201 and echocardiography. It is clearly shown  that Ambulatory Coronary Surgery is possible. More experience and technology    is necessary  to extend indications broadly.