Robotic surgery-stenting combo opens coronary arteries, speeds recovery

Combining robotically assisted coronary artery bypass surgery (CABG) with stented angioplasty shows promise for treating extensive coronary artery disease, researchers reported at the American Heart Association Scientific Sessions 2005.

"The minimally invasive procedure effectively bypassed or opened blocked arteries in all 27 patients, an outcome as good or better than you would expect with open chest surgery," said Marc R. Katz, M.D., lead author of the study and chief of cardiac surgery and director of the Virginia Transplant Center at Henrico Doctors' Hospital in Richmond.

"The patients stayed in the hospital an average of only two and a half days, compared with five or six days for conventional CABG surgery," Katz said. "And they were back to work in a week or so, compared with the usual six to 12 weeks."

The study involved patients with multi-vessel coronary disease, including obstruction of the left anterior descending coronary artery (LAD), the main artery in the front of the heart.

During the closed-chest bypass procedure, the left internal mammary artery (in the chest) was harvested. Doctors then sutured the mammary artery to the obstructed LAD, bypassing the obstruction, all done endoscopically.

During the angioplasty procedure, doctors used stents (mesh tubes) to unblock other arteries and then prop them open.

"Using the left internal mammary artery to bypass the LAD is the one thing we can do for patients with coronary artery disease that has a proven survival advantage," Katz said. "Here is a way to accomplish that and also open other vessels in a very minimally invasive way."

Robotic surgery involves making three small incisions, each about 1 cm ( inch) long, in the left side of the patient's chest. A 3-D scope with 10x magnification is inserted in the middle port, with the robotic right and left arms in the other ports. The daVinci robotic system is a powerful computer interface that al

Contact: Carole Bullock or Karen Astle
American Heart Association

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