1. I read about the transendoscopic coronary artery bypass grafting in Ladies Home Journal. I haven't heard of it. I know that my hospital isn't doing it. They are still on off-pump, occasionally using TMR.

    Any hospitals using this? What are the patient outcomes? Are some patients better candidates than others?

    I tried doing an internet search on it and only came up with what medicare was and was not going to pay for- go figure.

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    About moonshadeau, ADN, BSN, MSN, APN, NP, CNS

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  3. by   JohnnyGage
    Had to ask one of the surgeons about this one. Apparently TECAB is the new name for the old MIDCAB procedure where surgery was done through endoscopic ports in the chest.

    The patient is put on bypass through cannulation of a femoral artery and the vena cava (endoscopically); instead of a cross-clamp, a large balloon is sent up through the other femoral artery into the aorta and inflated to stop blood flow. The remainder of the surgery is done endoscopically.

    Unfortunately MIDCAB surgery wasn't very successful in humans because of the tight thoracic space -- the original experiments were done on canines which have a very rounded thorax.

    My source said that MIDCAB, or TECAB, is still being investigated and may have a new, successful life now that more advances have been made in the area of robtic-assisted surgery.

    It's interesting that you mention TMR. We used to do quite a few of those, but they too seem to have fallen out of fashion. Primarily used for palliative effects on inopperable patients, I never saw much improvement.