Gibber Marc, Lehr Eric J, Kon Zachary N, Wehman P Brody, Griffith Bartley P, Bonatti Johannes
From the *Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD USA; †Swedish Heart and Vascular Institute, Seattle, WA USA; and ‡Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH USA; and §Cleveland Clinic, Abu Dhabi, United Arab Emirates.
Innovations (Phila). 2014 Nov-Dec;9(6):448-50. doi: 10.1177/155698451400900610.
Preoperative colostomy presents a significant risk of sternal wound complications, mediastinitis, and ostomy injury in patients requiring coronary artery bypass grafting. Less invasive procedures in coronary surgery have a potential to reduce the risk of sternal wound healing problems. Robotic totally endoscopic coronary artery bypass grafting in patients with a colostomy has not been reported. We describe a case of completely endoscopic coronary surgery using the da Vinci Si system in a patient with a transverse colostomy. Single left internal mammary artery grafting to the left anterior coronary artery was performed successfully on the beating heart. We regard this technique as the least invasive method of surgical coronary revascularization with a potential to reduce the risk of surgical site infection and mediastinitis in patients with a colostomy.
