Endoscopic Multivessel Coronary Artery Bypass Grafting Using Automated Device for Proximal Anastomosis

Authors

  • Maurice-Andre Recanati
  • Jennifer K. White
  • James Titus
  • Arvind K. Agnihotri
  • David F. Torchiana

DOI:

https://doi.org/10.1532/hsf.783

Abstract

Background: The use of computer-enhanced telemanipulation robots in cardiothoracic surgery can reduce the need for open surgical access and enable closed-chest, endoscopic procedures, but these procedures have been limited to anterior target vessels. The feasibility of fully endoscopic multivessel, coronary artery bypass grafting (CABG) was examined.

Methods: Fully endoscopic, multivessel CABG solely through surgical ports was performed on 23 dogs weighing 75 to 85 pounds. A proximal anastomosis was made with the Symmetry bypass system aortic connector. The aorta was cross clamped, and cardioplegia solution was administered through the vein graft into the ascending aorta.

Results: Eighteen of 23 procedures yielded successful proximal anastomoses and 1 to 3 distal anastomoses.

Conclusion: Endoscopic anastomosis to the ascending aorta is feasible with the Symmetry bypass connector. Antegrade cardioplegia and aortic root venting can then be easily accomplished. This approach simplifies closed chest cardioplegic arrest for mulitivessel CABG.

References

Boyd WD, Rayman R, Desai ND, et al. 2000. Closed-chest coronary artery bypass grafting on the beating heart with the use of a computer-enhanced surgical robotic system. J Thorac Cardiovasc Surg 120:807-9.nCannon JW, Stoll JA, Selha SD, Dupont PE, Howe RD, Torchiana DF. 2003. Port placement planning in robot-assisted coronary artery bypass. IEEE Trans Rob Autom. In press.nChitwood WR, Wixon CL, Elbeery JR, Moran JF, Chapman WH, Lust RM. 1997. Video-assisted minimally invasive mitral valve surgery. J Thorac Cardiovasc Surg 114:773-80.nDogan S, Aybek T, AndreBen 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.nDuhaylongsod FG. 2002. Minimally invasive cardiac surgery defined. Arch Surg Review 135:296-301.nGlower DD, Komtebedde J, Clements FM, Debruijn NP, Stafford-Smith M, Newman MF. 1999. Direct aortic cannulation for port-access mitral or coronary artery bypass grafting. Ann Thorac Surg 68:1878-80.nGroh M, Grossi EA. 1999. Multivessel coronary bypass grafting with minimal access using cardiopulmonary bypass. Curr Cardiol Rep 1:331-4.nKappert U, Cichon R, Schneider J, et al. 2000. Closed-chest coronary artery surgery on the beating heart with the use of a robotic system. J Thorac Cardiovasc Surg 120:809-11.nKappert U, Schneider J, Cichon R, et al. 2001. Development of robotic enhanced endoscopic surgery for the treatment of coronary artery disease. Circulation 104:102-7.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 FW, Falk V, Diegeler A, et al. 2001. Computer-enhanced "robotic" cardiac surgery: experience in 148 patients. J Thorac Cardiovasc Surg 121:842-53.nNetter FH. 1989. Atlas of human anatomy. West Caldwell, NJ; Ciba-Geigy.nReichenspurner H, Boehm D, Gulbins H, et al. 1999a. Robotically assisted endoscopic coronary artery bypass procedures without cardiopulmonary bypass. J Thorac Cardiovasc Surg 118:960-1.nReichenspurner H, Damiano R, Mack M, et al. 1999b. Use of the voice-controlled and computer-assisted surgical system Zeus for endoscopic coronary artery bypass grafting. J Thorac Cardiovasc Surg 118:11-6.nShah DM, Leather RP, Darling RC 3rd, Chang BB, Paty PS, Lloyd WE. 1996. Long term results of using the in situ saphenous vein bypass. Adv Surg 30:123-40.nTalwalkar NG, Cooley DA. 1998. Minimally invasive coronary artery bypass grafting: a review. Cardiol Rev 6:345-9.n

Published

2005-02-07

How to Cite

Recanati, M.-A., White, J. K., Titus, J., Agnihotri, A. K., & Torchiana, D. F. (2005). Endoscopic Multivessel Coronary Artery Bypass Grafting Using Automated Device for Proximal Anastomosis. The Heart Surgery Forum, 6(6), E80-E84. https://doi.org/10.1532/hsf.783

Issue

Section

Articles