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Is there a role for robotic totally endoscopic coronary artery bypass in HIV positive patients?
Author(s) -
van Wagenberg Frans S.,
Lehr Eric J.,
Rehman Atiq,
Bonatti Johannes
Publication year - 2010
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.356
Subject(s) - medicine , artery , asymptomatic , bypass grafting , surgery , coronary artery disease , mammary artery , human immunodeficiency virus (hiv) , coronary artery bypass surgery , cardiology , family medicine
Background Performing cardiac surgery on HIV positive patients represents a significant risk of occupational exposure to surgeons and their support staff. In addition, the immunocompromized state of these patients may be a factor which could adversely influence the results. Totally endoscopic coronary artery bypass grafting (TECAB) in HIV patients has not been reported. Methods A male patient with HIV and Hepatitis C presented with three vessel coronary artery disease requiring surgical revascularization. Totally endoscopic coronary artery bypass grafting was performed. Using the da Vinci (R) surgical robot, the left and right internal mammary arteries were harvested and sutured to the second obtuse marginal branch and the left anterior descending artery respectively. Results The patient was discharged home on postoperative day six. At one month following the operation, the patient was asymptomatic and had returned to full activity without the need for sternal precautions. Conclusions We describe the first case of completely endoscopic coronary surgery using the da Vinci (R) system in an HIV patient. Double internal mammary artery grafting to the left coronary artery system was carried out successfully. Copyright © 2010 John Wiley & Sons, Ltd.