On-Pump Beating-Heart with Axillary Artery Perfusion: A Solution for Robotic Totally Endoscopic Coronary Artery Bypass Grafting?


  • Johannes Bonatti
  • Jose Garcia
  • Atiq Rehman
  • Patrick Odonkor
  • Reyaz Haque
  • David Zimrin
  • Bartley Griffith




Robotic totally endoscopic coronary artery bypass grafting (TECAB) can be performed on the arrested heart or on the beating heart without heart-lung machine support. In high-risk patients or in patients where technical difficulties are expected with a complete off-pump approach, a beating heart concept with heart-lung machine support can be an important option. Femoral arterial cannulation is associated with additional risk of retrograde cerebral embolization, and axillary cannulation is an accepted method in aortic surgery. We describe a case where an axillary artery cannulation method was used for the first time in TECAB performed with the da Vinci telemanipulation system.


Dogan S, Aybek T, Mierdl S, Wimmer-Greinecker G 2002. Totally endoscopic coronary artery bypass grafting on the arrested heart is a prerequisite for successful totally endoscopic beating heart coronary revascularization. Interactive CardioVascular and Thoracic Surgery 1:30-4.nMiyahara K, Matsuura A, Takemura H, et al. 2008. On-pump beating-heart coronary artery bypass grafting after acute myocardial infarction has lower mortality and morbidity. J Thorac Cardiovasc Surg 135:521-6.nRastan AJ, Bittner HB, Gummert JF, et al. 2005. On-pump beating heart versus off-pump coronary artery bypass surgery—evidence of pump-induced myocardial injury. Eur J Cardiothorac Surg 27:1057-64.nMizutani S, Matsuura A, Miyahara K, et al. 2007. On-pump beating-heart coronary artery bypass: a propensity matched analysis. Ann Thorac Surg 83:1368-73.nSchachner T, Vertacnik K, Laufer G, Bonatti J 2002. Axillary artery cannulation in surgery of the ascending aorta and the aortic arch. Eur J Cardiothorac Surg 22:445-7.nSrivastava S, Gadasalli S, Agusala M, et al. 2008. Robotically assisted beating heart totally endoscopic coronary artery bypass (TECAB). Is there a future? Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 3:52-8.n



How to Cite

Bonatti, J., Garcia, J., Rehman, A., Odonkor, P., Haque, R., Zimrin, D., & Griffith, B. (2009). On-Pump Beating-Heart with Axillary Artery Perfusion: A Solution for Robotic Totally Endoscopic Coronary Artery Bypass Grafting?. The Heart Surgery Forum, 12(3), E131-E133. https://doi.org/10.1532/HSF98.20091036