title: Is there a role for robotic totally endoscopic coronary artery bypass in HIV positive patients?
abstract: BACKGROUND
  Performing cardiac surgery on HIV positive patients represents a significant risk of occupational exposure to surgeons and their support staff. In addition, the immunocompromized state of these patients may be a factor which could adversely influence the results. Totally endoscopic coronary artery bypass grafting (TECAB) in HIV patients has not been reported.
  
  
  METHODS
  A male patient with HIV and Hepatitis C presented with three vessel coronary artery disease requiring surgical revascularization. Totally endoscopic coronary artery bypass grafting was performed. Using the da Vinci surgical robot, the left and right internal mammary arteries were harvested and sutured to the second obtuse marginal branch and the left anterior descending artery respectively.
  
  
  RESULTS
  The patient was discharged home on postoperative day six. At one month following the operation, the patient was asymptomatic and had returned to full activity without the need for sternal precautions.
  
  
  CONCLUSIONS
  We describe the first case of completely endoscopic coronary surgery using the da Vinci system in an HIV patient. Double internal mammary artery grafting to the left coronary artery system was carried out successfully.
authors.affiliation: Division of Cardiac Surgery, University of Maryland Heart Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland 21201, USA.
authors.forename: Frans S
authors.initials: FS
authors.lastname: van Wagenberg
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lehr
authors.forename: Atiq
authors.initials: A
authors.lastname: Rehman
authors.forename: Johannes
authors.initials: J
authors.lastname: Bonatti
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods*; D004724:Endoscopy; D006679:HIV Seropositivity / Q000150:complications*; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000379:methods*