• Johannes Bonatti, Thomas Schachner, Nikolaos Bonaros, Patrycja Jonetzko, Armin Ohlinger, Elisabeth Ruetzler, Christian Kolbitsch, Gudrun Feuchtner, Guenther Laufer, Otmar Pachinger, and Guy Friedrich.
• Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria. johannes.o.bonatti@i-med.ac.at
• Cardiology. 2008 Jan 1; 110 (2): 92-5.

ObjectivesHybrid coronary revascularization procedures apply minimally invasive coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of multivessel coronary artery disease. For logistic reasons simultaneous procedures would be desirable. In a pilot study the feasibility of simultaneous robotic totally endoscopic CABG and PCI using drug eluting stents was assessed.Patients And MethodsFive patients were scheduled to undergo simultaneous combined coronary intervention. A left internal mammary artery bypass graft was placed to the left anterior descending artery (LAD) in a completely endoscopic fashion using the daVinci telemanipulation system. PCI was carried out in the surgical operating room with the GE OEC9800 mobile coronary angiography C-arm. Rapamycin coated Cypher stents were placed into stenotic non-LAD targets.ResultsThe procedure was feasible in 4 patients, one patient was converted to a double CABG operation. There were no significant postoperative clinical complications and patients were discharged from intensive care unit and the hospital after 19 (18-61) hours and 6 (5-7) days respectively. At 6 months postoperatively all patients are free from angina.ConclusionWe conclude that simultaneous robotic totally endoscopic left internal mammary artery to LAD placement and PCI to non-LAD targets using drug eluting stents is feasible in one session.Copyright 2007 S. Karger AG, Basel.

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