New Hybrid CABG Surgery Offers Patient Benefits
Coronary artery bypass graft (CABG) surgery is one of the most important and often-performed procedures in cardiovascular surgery. It can relieve symptoms of coronary artery disease or prevent a heart attack when non-surgical treatments fail to widen a patient’s arteries. During an open CABG procedure, the surgeon makes a large chest incision and cuts through the patient’s breastbone to get to the heart. However, in recent years surgeons have been able to perform certain types of CABG surgeries with the aid of a robot thus eliminating the need for a breast bone splitting incision. Most recently, a small number of hospitals in the country have begun operating on patients with multi-vessel coronary artery disease using a hybrid procedure that combines coronary artery stents and robot-assisted CABG surgery. These minimally invasive techniques hold a range of benefits for patients.
Surgeons at University of Wisconsin Hospital and Clinics have been using the DaVinci surgical robot since early 2006. Surgeons currently use it to perform a host of complex surgeries, including prostatectomies, hysterectomies, and other complex cardiothoracic procedures. Compared to open surgery, minimally invasive heart surgery offers several benefits to the patient, such as shorter hospital stays, smaller incisions, and faster recoveries.
What is Hybrid CABG surgery?
Instead of receiving a breast bone splitting procedure, patients receiving the hybrid CABG surgery are getting “best of both worlds” treatments: CABG with mammary artery and percutaneous coronary intervention with stenting. From a pulmonary perspective, this is a significant advantage for our more elderly patients.
To perform the CABG procedure, cardiac surgeons need to create only three pen-sized holes in the patient’s skin in addition to a small sub-mammary incision. With the hybrid procedure, an interventional cardiologist places stents in one or several diseased coronary vessels that are not accessible to the robotic procedure. In some cases, stenting can be done a few hours following bypass surgery. In others, the patient may be discharged on optimal medical therapy and return days or weeks later to receive the stents.
The ideal patient
Patients with one- to three-vessel coronary artery disease who would normally get CABG through a median sternotomy can qualify for a hybrid approach. One of the more important uses for this procedure is in older patients whose aortas have become heavily calcified (a condition also known as “porcelain aorta”), where standard bypass grafting carries an increased stroke risk. Also, another important application of the hybrid procedure is in patients who may need to recover and return to work quickly. Recovery from robotic CABG and the hybrid procedure typically takes a few days. Recovery from the standard, open-sternum bypass can take weeks. For people who are limited in their ability to take time off work, and those who have to lift or work with heavy equipment, this is an excellent option for them.
For more information
UW Hospital and Clinics is one of a few centers nationwide to offer a hybrid procedure that combines stents and robotic CABG surgery for patients with multi-vessel coronary artery disease. This program is being pioneered by cardiac surgeon Lucian Lozonschi, MD, and interventional cardiologist Kurt Jacobson, MD. Visit the Heart, Vascular and Thoracic Care pages to learn more about CABG surgery and other cardiac treatments and programs at UW Health.