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Ann Thorac Surg 2004;77:1472-1474
© 2004 The Society of Thoracic Surgeons

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Robotically assisted left ventricular epicardial lead implantation for biventricular pacing: the posterior approach

Joseph J. Derose, Jr, MDa*, Scott Belsley, MDa, Daniel G. Swistel, MDa, Roxana Shaw, PAa, Robert C. Ashton, Jr, MDa

a Division of Cardiothoracic Surgery, St. Luke's-Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York, USA

Accepted for publication April 9, 2003.

* Address reprint requests to Dr DeRose, 1090 Amsterdam Ave, Suite 7A, New York, NY, USA 10025
e-mail: jjd11{at}columbia.edu

Patients with congestive heart failure and altered interventricular conduction enjoy improvements in quality of life and ventricular function after successful resynchronization therapy with biventricular pacing. Technical limitations owing to individual coronary sinus and coronary venous anatomy result in a 10% to 15% failure rate of left ventricular (LV) lead placement through percutaneous approaches. To provide a minimally invasive option for these patients with LV lead failures, we developed a technique of endoscopic, epicardial LV lead implantation with the use of the da Vinci robotic system. The surgical approach targets the posterolateral wall through a novel posterior approach.




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