title: Robot-assisted off-pump minimally invasive reoperative coronary artery bypass grafting: case report.
abstract: BACKGROUND
  Resternotomy for reoperative coronary artery bypass grafting (CABG) has become increasingly common with an aging patient population. Minimally invasive and robotic techniques permit us to perform these surgeries with reduced morbidity and mortality.
  
  
  METHODS
  A 67-year-old woman was taken to the operating room for repeat CABG. A free right internal mammary graft was endoscopically harvested using the da Vinci robotic operating system. A small left thoracotomy was then used to perform an off-pump bypass from the descending aorta to the hood of a diseased saphenous vein graft.
  
  
  CONCLUSIONS
  Robotic and minimally invasive cardiac surgery undergoes continuous refinement. As the incidence of reoperative surgery in patients with multiple previous interventions rises, surgeons will have to become increasingly creative with their choice of conduits, incisions, and the use of hybrid open and endoscopic techniques.
authors.affiliation: Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. tpm2102@columbia.edu
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Martens
authors.forename: Marco M
authors.initials: MM
authors.lastname: Hefti
authors.forename: Robert
authors.initials: R
authors.lastname: Kalimi
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Michael
authors.initials: M
authors.lastname: Argenziano
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009203:Myocardial Infarction / Q000601:surgery*; D012086:Reoperation; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome