Mount Sinai St. Luke’s Cardiothoracic Surgeons Successfully Perform First Closed Chest Coronary Bypass Procedure
Mount Sinai Heart is the only center in New York offering the specialized endoscopic surgery
Mount Sinai Heart has become the only center in New York State offering heart bypass surgery without major incisions or cutting through the breastbone. The procedure, known as totally endoscopic coronary arterial bypass surgery or TECAB, is performed using only micro-incisions and offers eligible patients a much quicker recovery and less pain, scarring, and risk of infection.
Two leading Mount Sinai Health System cardiothoracic heart surgeons—John Puskas, MD, and Gianluca Torregrossa, MD—performed the system’s first two TECAB procedures during the week of May 28 at Mount Sinai St. Luke’s.
TECAB is a highly technical approach to coronary artery bypass surgery, which is the most common heart surgery in the country. Its benefits also include no rib spreading and a reduced risk of stroke.
“We are proud and excited to have successfully performed this advanced coronary procedure at Mount Sinai St Luke’s,” says Dr. Puskas, Chair of Cardiovascular Surgery at Mount Sinai St. Luke’s, Mount Sinai Beth Israel, and Mount Sinai West. “We can now offer this less painful procedure with easier recovery for patients with severe coronary heart disease.”
“TECAB allows us to avoid any major chest incisions for our patients, giving them a dramatic improvement in postoperative recovery,” explains Dr. Torregrosa, Associate Director of Robotic Heart Surgery at Mount Sinai St. Luke’s. “The minimally invasive aspect of this procedure allows us to maximize the benefit of coronary artery bypass grafting even for those patients that are not ideal candidates for conventional surgery.”
Drs. Puskas and Torregrossa performed the TECAB surgeries—a single bypass and a double bypass—through four keyhole (fingertip-size) incisions less than one centimeter long. Standard bypass surgery involves a large chest incision that can be up to twelve inches long. The surgeons placed robotic instruments through the micro-incisions to harvest the mammary artery. Then, they used a highly specialized automatic device to connect the mammary artery to the coronary artery on the front wall of the heart and fired 13 tiny stainless steel clips to instantly hold the arteries together with a high degree of precision. In the traditional bypass procedure, the surgeon has to spread open the patient’s chest and sew the arteries together by hand.
With TECAB, patients can go home one to four days after surgery, and return to normal activities just one to two weeks later. Patients who have open-chest bypass are typically in the hospital for a week to 10 days and can’t go back to full activity for about three months.
“This is a very technically demanding procedure, with few bypass surgeons having enough skill or training to employ it. Our cardiac team is equipped to handle such intricate, advanced procedures and our modernized facility is outfitted with a state-of-the-art surgical robot to assist them,” says Arthur Gianelli, President of Mount Sinai St. Luke’s. “By offering this innovative bypass procedure at Mount Sinai St. Luke’s, our team leaps ahead in coronary artery bypass grafting surgery in New York and the Northeast and we are well positioned as one of the top cardiac programs in the world.”
Many bypass patients may qualify for TECAB. The best candidates are those with a limited number of blockages on the left side of the heart who want to avoid a traditional operation. Surgeons cannot perform TECAB on patients who have had previous heart surgery or exposure to cancer radiation therapy near the chest.
For more information on Mount Sinai Heart St. Luke’s visit this link: https://www.mountsinai.org/locations/st-lukes/care/heart
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