Reply to Letter to the Editor

Comments on “Is Single LIMA-LAD Bypass Appropriate for OPCAB Training?”

We want to thank for the insightful comment on our article. In this analysis, we focused on the safety of a training model for off-pump coronary artery bypass grafting with a single anastomosis to the left anterior descending artery (LAD).[1]

We agree that the LAD anastomosis is crucial and not easier compared with other vessels. However, single bypass grafting to other coronaries besides the LAD rarely occur. We aimed on focusing not just anastomotic skill performance but rather managing an entire case as an operator. Therefore, we chose this model to compare the safety of this procedure.

Managing surgical skills to accomplish a perfect anastomosis while working on a moving heart is part of the stepwise approach to learn off-pump surgery. This offers the assisting experienced surgeon a perfect visual of the anastomosis to correct stiches if necessary. Positioning the heart, prepping the coronary vessel, and insertion of a coronary shunt are in summary complex and crucial steps of this procedure.

In fact, our results showed the comparable postoperative outcome between trainees and experienced surgeons.

We hope this will clarify the issue and take the opportunity to thank the authors of the letter once again for their particular interest in our work.

Publication History

Received: 29 March 2024

Accepted: 28 May 2024

Article published online:
23 June 2024

• References

• 1 Naito S, Reichenspurner H, Sill B. Is Single LIMA-LAD Bypass Appropriate for OPCAB Training?. Thorac Cardiovasc Surg 2024; (e-pub ahead of print) DOI: 10.1055/a-2260-5218.