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Ann Thorac Surg 2005;79:2138-2141
© 2005 The Society of Thoracic Surgeons

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Case report

Robotic Totally Endoscopic Coronary Artery Bypass and Catheter Based Coronary Intervention in One Operative Session

^a Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria
^b Department of Cardiac Anesthesiology, Innsbruck Medical University, Innsbruck, Austria
^c Department of Cardiology, Innsbruck Medical University, Innsbruck, Austria

Accepted for publication December 10, 2003.

^_* Address reprint requests to Dr Bonatti, Department of Cardiac Surgery, University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria (E-mail: johannes.o.bonatti{at}uibk.ac.at).

A 56-year-old male patient underwent robotically assisted totally endoscopic left internal mammary artery (LIMA) to left anterior descending artery (LAD) grafting. After protamine administration complete heart block developed in the patient. On intraoperative angiography the LIMA to LAD graft was perfectly patent but an acute occlusion of the right coronary artery (RCA) was noted. We performed an immediate on table percutaneous coronary angioplasty and stent placement to the RCA. The heart regained sinus rhythm and the wall motion abnormalities on the back wall of the heart resolved. No clinical symptoms indicating ongoing myocardial ischemia were noted postoperatively. This case demonstrates that a hybrid procedure of robotic totally endoscopic coronary artery bypass grafting and catheter based coronary intervention is feasible in one simultaneous session.

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