Professor Zhang Yong is operating Recently, the world’s first case of coronary artery bypass with three lesions under a small incision was completed in Beijing Military General Hospital. This success marks a significant improvement in the minimally invasive heart bypass technology based on the original one. According to the chief surgeon of this operation – the executive deputy director of the heart, lung and vascular center of Beijing Military General Hospital, cardiac surgery expert Professor Zhang Yong, the patient Mr. Fu is 80 years old and was admitted to the hospital due to recurrent attacks of angina pectoris. The old man suffered from a variety of diseases, of which coronary artery disease was the most serious and potentially life-threatening disease at the time, as well as diabetes and upper respiratory tract infection. The coronary angiogram showed 50-60% stenosis of the left main stem, complete occlusion of the gyral branch from the beginning, 80% stenosis of the opening of the anterior descending branch, and multiple lesions in the opening, middle, distal and posterior trigeminal segments of the right coronary artery, with 95% stenosis at the most severe point, making the lesion quite complex. Prof. Yong Zhang presided over the meeting, and the Department of Stem 1, Cardiology and Cardiac Surgery discussed the old man’s condition in detail. The doctors thought that the old man was already 80 years old, the coronary vascular lesions were very serious and extensive, and only coronary artery bypass could solve the problem, but the patient was old, and doing conventional coronary artery bypass would cause great damage to the patient. This surgery is generally tolerated by the patient, but for the old and frail, the risk is great. How to reduce surgical damage and achieve the same therapeutic effect became the focus of discussion. It is understood that Professor Zhang Yong has thousands of cases of coronary artery bypass experience, and in 1999 in China was the first to carry out the application of small sternal incision in the lower part of the heart under the non-stop beating coronary artery bypass, accumulated hundreds of cases of experience in this operation, but the application of small incision to do coronary artery three branch lesions, means that through this small incision not only to do the heart in front and below the vascular bridge, but also to do the heart behind the vascular bridge, the difficulty of the operation to The procedure is much more difficult and qualitatively different from the previous small incision surgery, and there are no reports of such surgery in the Internet. Professor Zhang Yong consulted with Professor Hu Dayi, the director of the hospital’s Cardiopulmonary Vascular Center and a renowned cardiovascular specialist, and finally decided on the daring plan of using a lumpectomy to take the saphenous vein in the thigh, the radial artery in the left hand, and a small incision in the lower sternum to make a coronary artery bypass for the old man. During the surgery, Prof. Zhang Yong made a small incision of about 10 cm in the middle of the patient’s anterior chest, cut the sternum only about halfway, cut open the pericardium to check the patient’s coronary vessels first, and then took the internal mammary artery from this small incision. All three bridges were prepared, and Prof. Zhang Yong gently lifted the patient’s heart by hand, fixed it with special instruments, exposed the left anterior descending branch, explored the vessel, cut the vessel, and anastomosed the prepared internal mammary artery to this vessel, completing the first vessel anastomosis. Then the other two vessels (radial artery and saphenous vein) were first anastomosed to the aorta at one end. The most difficult part of the small incision surgery was the posterior heart anastomosis, and Professor Zhang applied the heart elevation technique so that each vessel of the heart was clearly visible. The two vessels behind the heart were clearly exposed and anastomosed with the radial artery and saphenous vein respectively, and three hours later, the operation with three “bridges” was successfully completed. Prof. Zhang Yong told the reporter that since the operation only cuts part of the sternum, the damage is much less than the traditional surgery. First, because the integrity of the sternum is not destroyed, the postoperative pain is significantly reduced, and complications such as incisional infection are significantly reduced. Second, the patient’s breathing is less affected, and it also facilitates postoperative coughing and sputum excretion. Third, the postoperative bleeding is less and blood transfusion is reduced. Fourth, the patient gets the same treatment effect with less damage and faster recovery. This procedure is very suitable for patients who are too old and weak to undergo large incision surgery.