title: Combined totally endoscopic robotic coronary bypass and mitral valve repair via right-sided ports.
abstract: We present a case of combined coronary artery bypass grafting and mitral valve (MV) repair using a robotic totally endoscopic right-sided approach. A 61-year-old man presented with fatigue due to significant mitral regurgitation and was found to have a tight stenosis in the mid left anterior descending artery. Using the da Vinci robotic system, the patient underwent a left internal mammary artery graft to the left anterior descending artery using the C-Port Flex A distal anastomotic device followed by a MV repair. Both procedures were performed endoscopically via right chest ports and right femorofemoral bypass successfully. The patient was discharged from the hospital 3 days postoperatively and returned to normal activity within 3 weeks after surgery. This case study shows the feasibility of using an endoscopic robotic approach in selected patients undergoing combined MV coronary artery bypass grafting surgery.
authors.affiliation: From the *University of Wisconsin, Madison, WI USA; †Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI USA; and ‡Division of Cardiology, Aurora Advanced Healthcare, Menomonee Falls, WI USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Maciolek
authors.forename: Dorothy J
authors.initials: DJ
authors.lastname: Krienbring
authors.forename: Efstathios S
authors.initials: ES
authors.lastname: Naum
authors.forename: Susan E
authors.initials: SE
authors.lastname: Arnsdorf
authors.forename: Husam H
authors.initials: HH
authors.lastname: Balkhy
mesh_terms: D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D018570:Risk Assessment; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome