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Advances Continue in Excela Health Heart Program

Advances Continue in Excela Health Heart Program

Robot-Assisted Surgery Minimally Invasive Alternative To Open Heart Surgery

GREENSBURG, PA, March 22, 2023 … Excela Health marks another milestone in the evolution of its structural heart program as clinicians now offer robot-assisted coronary artery bypass surgery (CABG). 

Excela Health cardiothoracic surgeon Hiroyuki Tsukui, MD, director of Excela’s heart surgery program, performed the health system’s first minimally invasive CABG this month, having deemed his patient an appropriate candidate for this technique.

Rather than the midline incision typically made during an open heart surgery which results in a zipper-length scar, Dr. Tsukui performed the surgery using the DaVinci robotic system through a series of keyhole-sized incisions on the side of the patient’s chest, which aligned with the openings between the ribs.  

As with other robot-assisted surgeries, the benefits of this technique include fewer days in hospital intensive care, lower complication rates, reduced pain, shorter overall recovery time and less scarring.

According to the American College of Cardiology, the use of minimally invasive techniques for coronary artery revascularization has been increasing with promising results. While the sternotomy approach – often referred to as open heart surgery – provides surgeons with a degree of versatility, the excellent success rates of robot-assisted heart surgeries has prompted wider use among cardiothoracic surgeons. 

In selecting an appropriate candidate for robotic CABG, Dr. Tsukui reviewed the patient’s medical history, including any pre-existing conditions. Excela’s initial case was a 65-year-old male who had experienced a heart attack last May, the result of blockage of the left anterior descending artery which encircles the heart.  Over the past 10 months, Excela cardiologists worked with the patient to manage his high blood pressure and high cholesterol, while determining whether his weight, chronic kidney disease and enlarged prostate were barriers to surgery.  Ultimately, the patient was considered an ideal choice because he needed a single vessel bypass of his left anterior descending artery to address his coronary heart disease. 

The most common applications for robotics have been single and double vessel CABG and mitral valve replacement, Excela Health cardiothoracic surgeons also will be employing robotic technology to make mitral valve repairs for patients for whom this method is appropriate.

Excela’s cardiothoracic surgeons have been recognized by the Society of Thoracic Surgeons (STS), which ranks the health system’s heart surgery program among the top 2 percent nationwide.

The honor comes in the form of a distinguished three-star rating from STS for patient care and outcomes in three separate categories: aortic valve replacement combined with coronary artery bypass grafting (AVR+CABG), isolated aortic valve replacement (AVR), and isolated coronary artery bypass grafting (CABG).  Historically, less that 10 percent of all programs within the STS database achieve this elite standing.

The three-star rating denotes the highest category of clinical quality within the STS rating system, and is considered one of the most sophisticated and highly regarded overall measures of quality in healthcare, rating the benchmarked outcomes of cardiothoracic surgery programs in the United States and Canada. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database participant.

Robot-assisted heart surgery is another in a growing list of procedures being performed at Westmoreland Hospital where Excela Health’s Heart Center is located.  

In addition to Dr. Tsukui, Excela’s cardiothoracic surgeons include Michael H. Culig, MD, MMM, and Mitsugu Ogawa, MD, PhD. Their Excela colleagues include electrophysiologists, interventional and noninvasive cardiologists who are part of the expanding complement of physicians and advanced practice providers within the Heart, Lung and Vascular Institute.

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