Angioplasty, robotically assisted keyhole bypass combo appears effective

NEW ORLEANS, Nov. 9 Combining stented angioplasty and robotically assisted "keyhole" bypass surgery is safe and may help patients with extensive cardiovascular disease, researchers reported at the American Heart Association's Scientific Sessions 2004.

Doctors performed the hybrid approach on 12 patients, all of whom remain free of chest pain, said Bernard De Bruyne, M.D., Ph.D., co-author of the report and head of the Catheterization Laboratory at the Cardiovascular Center in Aalst, Belgium.

"This technique puts together the best of both worlds," De Bruyne said. "However, it is important to emphasize that this is a small pilot study, and that robotically enhanced minimally invasive direct coronary artery bypass (MIDCAB) is a recent technique that is used in only a few centers worldwide."

Robotically enhanced MIDCAB is a minimally invasive procedure in which one or both internal mammary arteries (in the chest) are harvested with the help of a robot. Doctors then suture them to the obstructed coronary arteries through a left, keyhole mini-thoracotomy (about 2 inches wide) to supply blood below the obstruction.

"The fact that this key-hole surgery is performed without opening the chest and without arresting the heart offers patients the best postoperative comfort level and aesthetic results," said Frank Van Praet, M.D., senior author of the report and staff member of the department of cardiovascular and thoracic surgery at the OLV clinic in Aalst, Belgium.

Keyhole surgery involves cutting two small holes in a patient's chest, in addition to a larger hole (the mini-thoracotomy). The surgeon inserts a small light into the chest through one hole and a camera through the other. Surgical instruments are used in the larger hole. The surgeon holds instrument-like tools connected to a computer. Observing the heart on a monitor, the surgeon performs the delicate motions required by the operation. The computer interprets the surgeon's movements

Contact: Carole Bullock
American Heart Association

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