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A groundbreaking surgical achievement has been made by the team at West Virginia University (WVU) Heart and Vascular Institute, led by Dr. Vinay Badhwar, the executive chair of the WVU Heart and Vascular Institute and the second vice president of the Society of Thoracic Surgeons. On October 31, 2024, the team performed the world’s first combined robotic aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) through a single small incision.

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The pioneering procedure was performed on 73-year-old Poppy McGee, a patient with a complex medical history, including a stroke, brain surgery, and significant weight loss. Referred to Dr. Badhwar for treatment of both aortic valve disease and coronary artery disease, McGee initially faced the prospect of traditional open-heart surgery. However, when she and her family learned of its risks—over a 10% chance of mortality and nearly 50% likelihood of complications—they inquired about alternative options.

Dr. Badhwar explained his team had developed a novel robotic approach that had yet to be tested on a patient. After a thorough discussion of the risks and benefits, McGee and her family agreed to proceed with the innovative robotic surgery.

The procedure involved both AVR and CABG, performed entirely robotically through a single incision on the far right of McGee’s chest. The success of the surgery has sparked optimism about the potential for broader adoption of robotic heart surgery for patients with complex conditions.

“While we are still in the early days of this latest innovation, the ability to perform valve surgery and coronary artery bypass surgery fully robotically through a single incision has the potential to open up a new era of robotic heart surgery,” Dr. Badhwar noted in a prepared statement. “We must always keep quality outcomes at the forefront of all innovation. However, if surgeons adopt and gain experience with techniques such as this one, they will tackle this last frontier that previously limited a robotic approach. One day in the near future, this may serve as a platform to perform nearly all types of heart surgery.”

This revolutionary procedure potentially paves the way for less invasive operations. Dr. Lawrence Wei, a professor at the WVU Department of Cardiovascular and Thoracic Surgery, remarked on the impact of this advancement: "Patients who have both valve disease and coronary artery disease have traditionally been treated by open-heart surgery performed through the breastbone. This new robotic technique could redefine how we approach these cases."

Dr. Goya Raikar, an assistant professor at WVU and a member of Badhwar’s robotics team, also underscored the procedure's significance: "Until now, the main exclusion for us to perform a robotic approach has been the coexistence of valve and coronary artery disease. Building on our experience with robotic aortic valve surgery, this new approach may help us extend robotic surgery options to many more patients."

The patient’s daughter, Mollie Wilcosky, expressed gratitude for the groundbreaking care provided by the WVU team. “We are so thankful for Dr. Badhwar and the team at the WVU Heart and Vascular Institute for developing this robotic procedure to help my mother recover so well,” Wilcosky said. “She is getting stronger every day.”

The full details of the procedure will be in The Annals of Thoracic Surgery, highlighting how innovative approaches like this continue to redefine the future of cardiothoracic surgery.

References:
•    Cardiovascular Business article on the WVU Heart and Vascular Institute's groundbreaking surgery.
•    WV News article detailing the multidisciplinary team and procedural innovations at WVU Medicine’s WVU Heart and Vascular Institute.
 

The Society of Thoracic Surgeons (STS) and the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS) recently co-hosted the inaugural Aortic Summit 2024 in Tokyo, Japan. This international event brought together leading experts in the field to discuss advancements in the diagnosis and treatment of thoracic aortic lesions, including endovascular approaches.

The summit was designed to cater to a diverse audience, including cardiothoracic surgeons, cardiac anesthesiologists, CT residents, perfusionists, and ICU and OR nurses. 

The comprehensive three-day program covered a wide range of topics, including root, arch, descending aorta, TEVAR, dissection, and hybrid procedures. Participants had the opportunity to learn from experts, network with colleagues, and gain valuable insights into the latest techniques and technologies.

"The sessions delved into the latest developments through a series of presentations, panel discussions, and hands-on workshops," said Yutaka Okita, MD, Congress President for the STS-ASCVTS Aortic Summit 2024. "The event featured a number of eminent speakers from all over the world, who shared their expertise and achievements with attendees.”