This study was performed in nine Thiel/ethanol-fixed human cadavers. Concomitant coronary artery bypass grafting and valve procedures were carried out using a minimally invasive biaxillary access strategy. 

The assessment focused on:

•anatomical exposure

•internal thoracic artery conduit length

•graft harvesting

•anastomosis times

•valve implantation positioning

Postprocedural evaluation was performed by direct macroscopic inspection and three-dimensional computed tomography imaging.

All planned procedures were completed in all nine cadavers. Mean left and right internal thoracic artery lengths were 18.1 ± 1.8 cm and 18.9 ± 1.9 cm, respectively.

The average bilateral internal thoracic artery harvesting time was 52.0 ± 17.6 minutes, and the average anastomosis time was 46.6 ± 12.6 minutes. Postprocedural 3D CT imaging and macroscopic inspection confirmed appropriate graft positioning and valve seating in all specimens.

Conclusion: 

This cadaveric pilot study suggests that a minimally invasive biaxillary access strategy may provide adequate anatomical exposure and procedural workflow for concomitant CABG and valve surgery under experimental conditions. These findings should be interpreted as preliminary and do not establish clinical safety or efficacy. Further technical refinement, reproducibility testing, and clinical validation are required.