Totally Endoscopic Coronary Artery Bypass on the Beating Heart in Jehovah's Witness and HIV Patients: Case Report


  • Roberto Casula
  • Thanos Athanasiou



Minimally invasive direct coronary artery bypass has been widely employed as an approach for revascularization of the left anterior descending coronary artery. Recent advances in minimally invasive cardiac surgery enhanced with technological assistance have meant that these operations are now being performed through smaller incisions. We present 2 cases, both of which emphasize the beneficial role of the DaVinci robotic system in performing bloodless coronary surgery without blood transfusion and in reducing blood contact in instances in which there is a high risk for infection. In the first case, a Jehovah's Witness patient, blood transfusion was not an option; in the second case, a human immunodeficiency virus (HIV)-positive patient, blood contact would have put the staff at risk for HIV infection.


Casula RP, Athanasiou T, Cherian A, Bacon R, Foale R, Darzi A. 2003. Totally endoscopic robotically enhanced coronary artery bypass on the beating heart. J R Soc Med 96(8):400-1.nCisowski M, Drzewiecki J, Drzewiecka-Gerber A, et al. 2002. Primary stenting versus MIDCAB: preliminary report: comparison of two methods of revascularization in single left anterior descending coronary artery stenosis. Ann Thorac Surg 74(4):S1334-9.nFalk V, Jacobs S, Gummert JF, Walther T, Mohr FW. 2003. Computer-enhanced endoscopic coronary artery bypass grafting: the Da Vinci experience. Semin Thorac Cardiovasc Surg 15(2):104-11.nFrater RW. 2000. Cardiac surgery and the human immunodeficiency virus. Semin Thorac Cardiovasc Surg 12(2):145-7.nGoodnough LT, Brecher ME, Kanter MH, AuBuchon JP. 1999. Transfusion medicine, part I: blood transfusion. N Engl J Med 340:439-47; 342:1666-8.nMagee MJ, Mack MJ. Robotics and coronary artery surgery. 2002. Curr Opin Cardiol 17(6):602-7.nQuebbeman EJ, Telford GL, Hubbard S, et al. 1991. Risk of blood contamination and injury to operating room personnel. Ann Surg 214(5): 614-20.nRiess FC, Bader R, Kremer P, et al. 2002. Coronary hybrid revascularization from January 1997 to January 2001: a clinical follow-up. Ann Thorac Surg 73(6):1849-55.nSpahn DR, Casuutt M. 2000. Eliminating blood transfusions: new aspects and perspectives. Anesthesiology 93(1):242-55.nStahl KD, Boyd WD, Vassiliades TA, Karamanoukian HL. 2002. Hybrid robotic coronary artery surgery and angioplasty in multivessel coronary artery disease. Ann Thorac Surg 74(4):S1358-62.n



How to Cite

Casula, R., & Athanasiou, T. (2009). Totally Endoscopic Coronary Artery Bypass on the Beating Heart in Jehovah’s Witness and HIV Patients: Case Report. The Heart Surgery Forum, 7(2), E174-E176.