Thorac Cardiovasc Surg 2016; 64(03): 230-235
DOI: 10.1055/s-0035-1562938
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

On-Pump Nonrobotic Total Endoscopic Coronary Artery Bypass Grafting: An Animal Study

Hagen Gorki
1   Department of Cardiothoracic and Vascular Surgery, University Hospital, Ulm, Germany
,
Jun Liu
1   Department of Cardiothoracic and Vascular Surgery, University Hospital, Ulm, Germany
,
Frank Poelzing
2   Institute of Innovative Medicine, Beichlingen, Germany
,
Susanne D. Gorki
3   Department of Cardiology, Zentralklinik Bad Berka GmbH, Bad Berka, Germany
,
Heidi Pasche
2   Institute of Innovative Medicine, Beichlingen, Germany
,
Guenter Albrecht
1   Department of Cardiothoracic and Vascular Surgery, University Hospital, Ulm, Germany
,
Andreas Liebold
1   Department of Cardiothoracic and Vascular Surgery, University Hospital, Ulm, Germany
› Author Affiliations
Further Information

Publication History

23 February 2015

18 June 2015

Publication Date:
02 September 2015 (online)

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Abstract

Background Total endoscopic coronary artery bypass grafting (TECAB) is currently performed exclusively with the help of a telemanipulator. After extensive practice in a biomechanical model, the operation was performed as a nonrobotic approach in an animal study.

Methods Six large domestic pigs were anesthetized and intubated. Port access and endoscopic vision were used exclusively during the intrathoracic procedure. In five animals, an internal mammary artery was harvested, extracorporeal circulation was established via peripheral vessel access, and the ascending aorta occluded with an intraluminal balloon. In cardioplegic arrest, an anastomosis of internal mammary artery and left anterior descending coronary artery was performed with shortened 7–0 monofil thread running suture. As a terminal study, the animals were humanely killed and the quality of the anastomoses was checked.

Results After a steady learning curve, the fifth animal was operated on successfully and a satisfactory anastomosis was documented.

Conclusion Despite demanding differences to humans as shape of thoracic cavity and size of peripheral access vessels, the viability of the nonrobotic TECAB concept was documented in a living animal model.

Note Added in Proof

Meanwhile, two patients were operated on successfully with this technique at University Hospital of Ulm, Germany.