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
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.