University Hospitals Now Performing Robotic Heart Bypass Surgeries

CLEVELAND – A new, robotic approach to heart bypass surgery is now being offered to patients at University Hospitals (UH) with great success. Two UH Harrington Heart & Vascular Institute providers, Dr. Kelsey Gray and Dr. Pablo Ruda Vega, are currently the only surgeons in Ohio performing this specific type of procedure using the Da Vinci surgical robot. This robot assists surgeons in performing coronary artery bypass grafting (CABG) through a minimally invasive approach which leaves patients with less pain and a shorter recovery after surgery. 

A CABG is a surgical procedure that improves blood flow to the heart by diverting blood around blocked or narrowed coronary arteries that can lead to a heart attack if not addressed. A traditional CABG involves a sternotomy, known as “open heart surgery” – cutting the breastbone to access the heart – and placing the patient on a heart-lung machine to stop the heart from beating and circulate the blood. A minimally invasive direct coronary artery bypass (MIDCAB), originally developed in the mid-1990s, accomplishes the same goal without the sternotomy and heart-lung machine. It is performed on a fully beating heart through a small incision in the left chest.

Robotic MIDCABs using the Da Vinci robot are less invasive than a standard MIDCAB. This procedure requires only a few small incisions that doctors use to insert robotic arms and a camera for viewing. Surgeons manipulate the robotic arms to perform surgery while viewing magnified images from the camera on a console screen.

“With robotic surgery, patients experience less post-operative pain, have a shorter stay in the hospital, and return to normal activities more quickly,” said Dr. Gray, cardiac surgeon with UH Harrington Heart & Vascular Institute. “The robot also gives the surgeon more options and more flexibility during the procedure.”

“Many times, patients have the choice about which type of surgery they want to pursue. If they qualify, it’s easy to make the case for them for robotic surgery,” said Dr. Ruda Vega. Dr. Gray adds, “We tell them they’re going to live longer. They’re going to do better. They’re going to have more freedom from re-intervention, and they don't have to have a big sternotomy.”

While beneficial, this type of surgery is uncommon because it is technically challenging and requires the surgeon to be skilled with coronary artery bypass grafting off the heart-lung machine and also have mastery of the robot. Dr. Gray has a significant amount of experience with robotic surgery and Dr. Ruda Vega is an expert in “off-pump” surgery. This combination uniquely positioned UH Harrington Heart & Vascular Institute to launch a robotic MIDCAB program and begin performing this type of surgery in December 2023. UH also uses the Da Vinci robot to perform other cardiac surgeries including minimally invasive coronary artery bypass grafting, epicardial lead placement, ablation for atrial fibrillation, ligation of the left atrial appendage, and pericardial resection.   

Implementing a robotics program is just another proof point for UH Harrington Heart & Vascular Institute as a national leader in MIDCAB. According to device supplier data, it is ranked #4 in the country for MIDCAB volume.

“We have become one of the biggest centers in the country because we are truly a team,” said Dr. Ruda Vega. 

Drs. Gray and Ruda Vega perform robotic MIDCABs at UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center with plans to expand to regional UH medical centers in the coming months. They see patients in a specialized Robotic and Minimally Invasive Heart Surgery Clinic at UH Ahuja Medical Center (Beachwood) and UH Minoff Health Center (Orange Village). For more information, interested patients can call 216-844-4004.