title: Endoscopic multivessel coronary artery bypass grafting using automated device for proximal anastomosis.
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 hav e 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardiac Surgical Unit, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Maurice-Andre
authors.initials: MA
authors.lastname: Recanati
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: White
authors.forename: James
authors.initials: J
authors.lastname: Titus
authors.forename: Arvind K
authors.initials: AK
authors.lastname: Agnihotri
authors.forename: David F
authors.initials: DF
authors.lastname: Torchiana
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001026:Coronary Artery Bypass / Q000379:methods*; D004285:Dogs; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D006324:Heart Arrest, Induced / Q000379:methods; D023421:Models, Animal