To care for patients with multiple blocked vessels and symptoms of coronary heart disease, heart surgeons such as Lankenau Heart Institute’s Dr. Francis Sutter—the most experienced, minimally invasive robotic heart bypass surgeon in the country—work with interventional cardiologists to offer a hybrid approach to restoring blood flow to the heart muscle. The hybrid approach involves a combination of coronary stent placement and robotic-assisted coronary artery bypass graft (CABG), the placement of bypass grafts to help blood move around blocked heart arteries.
About 40 percent of all robotic-assisted CABGs performed at Lankenau use the hybrid approach.
Advanced technology eliminates need for heart-lung machine
CABG surgery can be performed using two very different technologies: with the heart stopped (while a heart-lung machine does the job of the heart, pumping blood throughout the body), or with the heart beating, also called off-pump or beating heart bypass surgery. Ninety-nine percent of CABG surgeries at Lankenau are performed using the beating heart (off-pump) technique.
Traditionally, heart-lung machines were used along with medication so that surgery could be performed on a motionless heart. With beating heart surgery, the heart-lung machine, as well as the associated side effects from having the heart stopped and blood pumped through this complex device, is no longer needed. Advances in technology allow for beating heart bypass surgery to be performed while the heart is still beating and functioning as normal.
Minimally invasive approaches to CABG surgery
Depending on the condition of the patient and consultation between the surgeon and cardiologist, beating heart bypass may be performed with traditional "open-heart" surgery or minimally invasive, robotic-assisted keyhole coronary revascularization.
Another minimally invasive approach is endoscopic harvesting of veins from the legs and/or radial artery from the arm. With this approach an endoscope is connected to a video camera and inserted through a one-inch opening to view and remove veins and arteries to be used as bypass grafts, to channel the blood.
Lankenau Medical Center is one of the highest volume robotic coronary artery bypass heart surgery centers in the country, performing over 1,400 procedures since 2005.
Advantages of beating heart bypass surgery for patients
Benefits for patients undergoing this cutting-edge surgery include:
- Quicker recovery
- Fewer cognitive and neurologic consequences, such as confusion or stroke
- Shorter hospital stays
- Decreased mortality
- Reduced need for blood transfusions
Beating heart bypass surgery progresses much faster than traditional, on-pump coronary bypass, so that the patient is under anesthesia for a shorter period of time. The patient awakens quicker and brighter, talks with family, gets out of bed the same day, and begins cardiac rehabilitation—on the way to an improved quality of life. This technique also decreases pain and healing time, resulting in a faster recovery.
Over the past 25 years, the Lankenau Medical Center has been an academic training center for surgeons, nurses and health care professionals—from across the nation and internationally—for the beating heart technique as well as other minimally invasive cardiac surgery procedures.
See Dr. Sutter Perform a robotic-assisted coronary artery bypass graft
Lankenau Medical Center has one of the most experienced robotic heart surgeons in the United States. Dr. Francis Sutter has performed more minimally invasive, robotic-assisted bypass surgery procedures than any other surgeon in the country.
Watch Dr. Sutter Perform a Robotic-Assisted Coronary Artery Bypass Graft
Warning: This video contains footage of actual surgery which may be disturbing to some viewers.