Robotically Assisted Minimally Invasive Off-pump Coronary Artery Bypass Surgery in a Patient With Permanent Tracheostomy

Abstract Background Patients with a permanent tracheostomy requiring coronary surgery represent a unique challenge, being at increased risk of sternal wound complications, mediastinitis and stoma necrosis. Several techniques have been described including manubrium sparing sternotomy, thoracoscopic i...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2017-11, Vol.26 (11), p.e65-e67
Main Authors: Ramponi, Fabio, MD, Flynn, Campbell D., MBBS, Wilson, Michael K., FRACS
Format: Article
Language:English
Subjects:
Cardiovascular
Coronary Artery Bypass, Off-Pump - methods
Coronary bypass
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures - methods
Robotic
Robotic Surgical Procedures - methods
Tracheostomy
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Summary:Abstract Background Patients with a permanent tracheostomy requiring coronary surgery represent a unique challenge, being at increased risk of sternal wound complications, mediastinitis and stoma necrosis. Several techniques have been described including manubrium sparing sternotomy, thoracoscopic internal mammary harvest and hybrid revascularization. How to do it We report a case of robotic assisted ( daVinci® Xi™ Surgical System) total arterial off-pump revascularization in a patient with previous laryngectomy and permanent tracheostomy. The main advantage of this approach was to minimize the risk of post-operative sternal complication and mediastinatis, whilst still providing the prognostic benefit of total arterial grafting and the neurological advantage of the aorta no-touch technique.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2017.02.025