A robotic hybrid procedure combining totally endoscopic double vessel CABG and PCI is feasible and can provide excellent mid-term symptom relief in selected patients with triple-vessel disease.
May support hybrid robotic revascularization in selected cases; hypothesis-generating and leaves open need for prospective validation.
A 56-year old man presented with increasing angina pectoris. Coronary angiogram showed a triple-vessel disease, with significant lesions on the main stem, on an obtuse marginal branch of the circumflex coronary artery (Cx), on the right coronary artery (RCA), and a proximal occlusion of the left anterior descending artery (LAD). A hybrid procedure was decided, with a beating heart totally endoscopic double vessel coronary artery bypass grafting (Double BHTECAB) on the LAD and the Cx, with the use of a four-arm robotic device, and a stent placement into the RCA in a second step. Both procedures went uneventfully, and the patient is fully asymptomatic 15 months after the procedure.
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Jansens et al. (2009) studied this question.
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