Totally Endoscopic Coronary Artery Bypass Grafting on the Arrested Heart


  • Marc R. Katz
  • Johannes O. Bonatti



In the late 1990s, totally endoscopic coronary artery bypass grafting was successfully introduced into the heart surgery armamentarium using robotic techniques. Surgeons have applied the daVinci telemanipulation system in order to develop completely endoscopic placement of internal mammary artery bypass grafts, mainly to the left anterior descending artery system. Multivessel procedures are currently under development. These operations can be carried out on the arrested heart using remote access perfusion and cardioplegic arrest via ascending aortic balloon occlusion. Another option is performing procedures on the beating heart using an endostablilizer and local coronary artery occlusion. In this review, the technique and specific aspects of the arrested heart version of totally endoscopic coronary artery bypass grafting are outlined.


Argenziano M, Katz M, Bonatti J, et al, TECAB trial investigators. 2006. Results of the prospective multicenter trial of robotically assisted totally endoscopic coronary artery bypass grafting. Ann Thorac Surg 81:1666-74.nAybek T, Dogan S, Andreben E, et al. 2000. Robotically enhanced totally endoscopic right internal thoracic coronary artery bypass to the right coronary artery. Heart Surg Forum 2000;3:322-4.nBonatti J, Schachner T, Bernecker O, et al. 2004. Robotic totally endoscopic coronary artery bypass: program development and learning curve issues. J Thorac Cardiovasc Surg 127:504-10.nBonatti J, Schachner T, Bonaros N, et al. 2005. Ongoing procedure development in robotically assisted totally endoscopic coronary artery bypass grafting (TECAB). Heart Surg Forum 8:E287-91.nBonatti J, Schachner T, Bonaros N, Laufer G. 2006. A new exposure technique for the circumflex coronary artery system in robotic totally endoscopic coronary artery bypass grafting. Interact Cardiovasc Thorac Surg 5:279-81.nBonatti J, Schachner T, Bonaros N, et al. 2006. Technical challenges in totally endoscopic coronary artery bypass grafting. JTCVS 131:146-53.nDamiano R, Ehrman W, Ducko C, Tabaie H, et al. 2000. Initial United States clinical trial of robotically assisted endoscopic coronary artery bypass grafting. J Thorac Cardiovasc Surg 119:77-82.nDamiano R. 2000. Editorial: endoscopic coronary artery bypass grafting—the first steps on a long journey. J Thorac Cardiovasc Surg 120:806-7.nDogan S, Aybek T, Andressen E, et al. 2002. Totally endoscopic coronary artery bypass grafting on cardiopulmonary bypass with robotically enhanced telemanipulation: report of forty-five cases. J Thorac Cardiovasc Surg 123:1125-31.nFalk V, Diegeler A, Walther T, e al. 2000. Total endoscopic computer enhanced coronary artery bypass grafting. Eur J Cardiothorac Surg 17:38-45.nFalk V, Gummert J, Walther T, Hayase M, Berry G, Mohr F. 1999. Quality of computer enhanced totally endoscopic coronary bypass graft anastomosis—comparison to conventional technique. Eur J Cardiothorac Surg 15:260-65.nFalk V, Jacobs S, Mohr F. 2003. Closed chest robotically assisted CABG. MMCTS 2003.000934.nGuthart G, Salisbury J. 2000. The Intuitive Telesurgery system: overview and application. Proc IEEE ICRA, San Francisco, CA.nJacobs S, Falk V, Onnasch J, Mohr F. 2003. Thorakoskopische Koronarchirurgie. Stand und Entwicklungsmöglichkeiten Chiurg 74:310-14.nJacobs S, Falk V. 2001. Pearls and pitfalls: lessons learned in endoscopic robotic surgery—the daVinci experience. Heart Surg Forum 4:307-10.nKappert U, Cichon R, Schneider J, Schramm I, Schüler S. 2000. Closed chest bilateral mammary artery grafting in double-vessel coronary artery disease. Ann Thorac Surg 70:1699-701.nKappert U, Schneider J, Cichon R, et al. 2001. Development of robotic enhanced endoscopic surgery fort the treatment of coronary artery disease. Circulation 2001;104(suppl I):I102-7.nKatz MR, Van Praet F, deCanniere D, et al. 2006. Integrated coronary revascularization: percutaneous coronary intervention plus robotic totally endoscopic coronary artery bypass. Circulation 114:I473-6.nLoulmet D, Carpentier A, d'Attellis N, et al. 1999. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg 118:4-10.nMohr F, Falk V, Diegeler A, Autschbach R. 1999. Computer enhanced coronary artery surgery. J Thorac Cardiovasc Surg 117:1212-5.nMohr F, Falk V, Diegeler A, et al. 2001. Computer enhanced robotic cardiac surgery: Experience in 148 patients. J Thorac Cardiovasc Surg 121:842-53.nOehlinger A, Bonaros N, Schachner T, Ruetzler E, Friedrich G, Laufer G, Bonatti J. 2007. Robotic endoscopic left internal mammary artery harvesting—what have we learned after 100 cases? Ann Thorac Surg [in press].nSchachner T, Bonaros N, Feuchtner G, Muller L, Laufer G, Bonatti J. 2005. How to handle remote access perfusion for endoscopic cardiac surgery. Heart Surg Forum 2005;8:E232-5.nSchachner T, Feuchtner GM, Bonatti J, et al. 2007. Evaluation of robotic coronary surgery with intraoperative graft angiography and postoperative multislice computed tomography? Ann Thorac Surg [in press].nStein H, Cichon R, Wimmer-Greinecker G, Ikeda M, Hutchinson D, Falk V. 2003. Totally endoscopic multivessel coronary artery bypass surgery using the daVinci Surgical System: a feasibility study on cadaveric models. Heart Surg Forum 6:E183-90.nStevens J, Burdon T, Peters W, et al. 1996. Port Access coronary artery bypass grafting: a proposed surgical method. J Thorac Cardiovasc Surg 111:567-73.nWimmer-Greinecker G, Deschka H, Aybek T, Mierdl S, Moritz A, Dogan S. 2004. Current status of robotically assisted coronary revascularization. Amer J Surg 188(supp):76s-82s.nWimmer-Greinecker G, Dzemali O, Aybek T, et al. 2005. Perfusion strategies for totally endoscopic cardiac surgery. MMCTS 2005.001206n



How to Cite

Katz, M. R., & Bonatti, J. O. (2007). Totally Endoscopic Coronary Artery Bypass Grafting on the Arrested Heart. The Heart Surgery Forum, 10(4), E338-E342.