title: Computer-assisted endoscopic coronary artery bypass anastomoses: a chronic animal study.
abstract: BACKGROUND
  With traditional instruments, endoscopic coronary artery bypass grafting (ECABG) has not been possible. This study was designed to determine the feasibility of using a robotically-assisted microsurgical system to perform ECABG in a chronic animal model.
  
  
  METHODS
  Nine calves were placed on cardiopulmonary bypass after harvesting the left internal mammary artery (LIMA). Subxiphoid endoscopic ports (2 instrument, 1 camera) were placed, and a robotic system was used to perform ECABG between the LIMA and left anterior descending coronary artery. LIMA graft flow (LIMAQ) was measured. Animals were sacrificed at 1 month, and hearts underwent angiographic and histologic analyses.
  
  
  RESULTS
  Acute graft patency was 89% (8/9). Two animals died suddenly within the first 48 hours. There was no significant difference in mean acute and chronic (n = 6) LIMAQ (40.9+/-4.7 and 38.5+/-5.0 ml/min, respectively). Survivors had an angiographic patency rate of 100% (6/6), confirmed by histology.
  
  
  CONCLUSIONS
  This study shows that ECABG is feasible in a chronic animal model with excellent results.
authors.affiliation: Department of Surgery, The Milton S. Hershey Medical Center, Penn State Geisinger Health System, Hershey 17033, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Stephenson
authors.forename: C T
authors.initials: CT
authors.lastname: Ducko
authors.forename: S
authors.initials: S
authors.lastname: Sankholkar
authors.forename: E M
authors.initials: EM
authors.lastname: Hoenicke
authors.forename: G A
authors.initials: GA
authors.lastname: Prophet
authors.forename: R J
authors.initials: RJ
authors.lastname: Damiano
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002417:Cattle; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D003326:Coronary Circulation; D004452:Echocardiography; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D012371:Robotics; D013813:Therapy, Computer-Assisted; D014654:Vascular Patency