Robotic Cardiac Surgery

Why Choose University Hospitals Harrington Heart & Vascular Institute for Your Robotic Cardiac Surgery?

University Hospitals (UH) Harrington Heart & Vascular Institute’s cardiac surgery program is consistently ranked in the top 1 percent of hospitals nationwide. Our team provides advanced minimally invasive and complex cardiac surgery techniques available only at select other institutions across the country.

In fact, as of early 2024, UH Harrington Heart & Vascular Institute cardiac surgeons are the only specialists performing robotic minimally invasive coronary artery bypass grafting in Ohio. Robotic MIDCAB surgeries are currently offered at University Hospitals Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center with plans to expand to regional University Hospitals medical centers in the coming months.

UH Harrington Heart & Vascular Institute has performed more than 200 minimally invasive MIDCAB procedures since first offering this option in the fall of 2021. The first robotic MIDCAB at UH was performed in December 2023, and has quickly surpassed 30 robotic MIDCAB surgeries in the first few months with notable patient outcomes.

Due to the fast growth of our robotic cardiac surgery program, we now offer a specialized Robotic and Minimally Invasive Heart Surgery Clinic at University Hospitals Ahuja Medical Center (Beachwood, Ohio) and University Hospitals Minoff Health Center (Orange Village, Ohio) for patient consultations.

Who is a Candidate for Minimally Invasive Robotic Coronary Artery Bypass Grafting?

Minimally invasive robotic coronary artery bypass surgery may be recommended to improve blood flow to your heart as a result of coronary artery disease. This surgery creates a new pathway for blood to flow around a blocked or narrowed artery in the heart, using part of a healthy blood vessel from another part of the body.

What Procedures Are Performed Using Robotic Cardiac Surgery?

At University Hospitals Harrington Heart & Vascular Institute, we use the da Vinci robot to perform minimally invasive cardiac surgery.

These procedures include:

• Minimally invasive coronary artery bypass grafting
• Epicardial lead placement
• Ablation for atrial fibrillation (Convergent procedure)
• Ligation of the left atrial appendage
• Pericardial resection

In the near future, we will also use the da Vinci robot to perform:

• Minimally invasive mitral and tricuspid valve repair/replacement
• Atrial septal defect/patent foramen ovale (PFO) closure
• Resection of intracardiac masses/tumors

Robotic Cardiac Surgery Vs. Traditional Cardiac Surgery – A difference in approach

Traditional cardiac surgery requires entry into the chest via a sternotomy; this requires a 6- to 8- inch incision that runs the length of the sternum. The sternum is then divided. At the end of the surgery, the sternum is put back together with wires or plates that hold the sternum together while it heals. Healing of the bone takes about 6 weeks, during which time patients cannot drive or do any heavy lifting.

In contrast, robotic cardiac surgery is minimally invasive and requires only a few small incisions to be made between the ribs. Patients are able to return to driving and resume their regular activities without restrictions shortly after surgery.

Potential Benefits of Robotic Cardiac Surgery

Robotic cardiac surgery offers a number of benefits for patients including:

• Shorter hospital stays.
• Faster recovery and return to normal activities.
• Less scarring, pain and risk of infection.
• Less blood loss and need for blood transfusions.
• Reduced risk of stroke.
• Higher patient satisfaction.

Risks of Robotic Cardiac Surgery

Although less invasive than traditional cardiac surgery, there are still risks associated with robotic surgery. In some cases these risks are less than with traditional open surgery.

Based on your medical condition, your healthcare provider will discuss what your specific risks are prior to your surgery.

What Happens Before Robotic Cardiac Surgery?

To determine if you’re a good candidate for robotic cardiac surgery, your doctor will review your medical history and your heart condition. Your provider will also conduct a physical exam to make sure you are healthy enough undergo the procedure. In addition, your provider may order blood tests and/or other diagnostic tests. Once you are approved for the surgery, your care team will provide you with specific instructions to prepare for procedure.

What Happens During Robotic Heart Surgery?

During robotic cardiac surgery, the surgeon is always in complete control of the surgical tools. The robotic “arm and wrist” motions mimic those of the surgeon, but are more precise.

Every procedure is different, but typically proceeds as follows:

1. Three small incisions are made in the spaces between the ribs. The largest of these incisions is often called the “the working port.”
2. Robotic arms help guide the surgical tools and a camera through the ports.
3. A camera is controlled using a foot pedal, allowing the surgeon to zoom in and out as necessary.
4. All surgical tools are removed before closing the incisions.

What Happens After Robotic Cardiac Surgery?

Following robotic cardiac surgery, most patients stay in the hospital for several days. Most people can manage their post-surgical pain with over-the-counter pain relievers such as ibuprofen or acetaminophen. Your healthcare provider will give you instructions about how to keep your surgical incisions clean and dry.

Most people can resume normal activities after a few weeks. Your doctor may provide specific recommendations for exercise and lifestyle changes to optimize your heart health and arrange for follow-up appointments to monitor your progress.