University Hospitals Robust Robotic Cardiac Surgery Program Treats 100+ Patients

CLEVELAND - University Hospitals is marking one year since introducing a new program and helping more than 100 patients with a novel, robotic approach to heart bypass surgery. Two UH Harrington Heart & Vascular Institute surgeons, Dr. Pablo Ruda Vega and Dr. Kelsey Gray, were the first in the state of Ohio to perform coronary artery bypass grafting (CABG) with the Da Vinci surgical robot. This minimally invasive approach leaves patients with less pain and a shorter recovery after surgery.

Since launching the endeavor in December of 2023, the surgeons' expertise has allowed them to build a robust program completing eight to 10 procedures per month on average, more than 100 total at UH Cleveland Medical Center, making this one of the highest volume programs in the country. Since higher volumes result from experienced physicians, quality outcomes for patients correlate as well.

"While beneficial, this type of surgery is uncommon at centers across the country because it is technically challenging and requires expert skill with both the robot and coronary artery bypass grafting off the heart-lung machine," said Dr. Ruda Vega, director of cardiac surgery at UH Cleveland Medical Center. "Combined, Dr. Gray and I have the experience needed to confidently complete successful surgeries with outstanding patient outcomes."

That's exactly what Wesley Collins of Ravenna experienced when he underwent a robotic MIDCAB at UH Cleveland Medical Center in July of 2023.

"You're expecting it to be real painful, but it wasn't," said the 66-year-old. "I've known people who had open heart surgery and there's definitely a huge difference between the two. I've only got a few little scars, not that big one up and down my whole chest."

Collins says within three weeks of his surgery he returned to the golf course. After a traditional CABG, doctors generally tell patients to wait at least four to six weeks before driving a car.

A CABG is a surgical procedure that improves blood flow to the heart by diverting blood around blocked or narrowed coronary arteries. It involves a sternotomy - cutting the breastbone to access the heart - and placing the patient on a heart-lung machine. A minimally invasive direct coronary artery bypass (MIDCAB) accomplishes the same goal without the sternotomy and heart-lung machine. It is performed on a fully beating heart through an incision in the left chest. An even less invasive option is a robotic MIDCAB. This procedure, using the Da Vinci robot, 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.

"Our team of experts is not just performing these novel surgeries, but we're routinely incorporating other needed interventions at the same time," said Dr. Yasir Abu-Omar, cardiothoracic surgeon; Surgical Director of the Advanced Heart Failure & Transplant Center; and Russ and Connie Lincoln Chair in Cardiovascular Innovation at UH Harrington Heart & Vascular Institute. "This tailored approach allows us to best serve our patients' needs by responding to their unique level of coronary artery disease."

During a robotic MIDCAB at UH, qualified patients can also receive:

• Not just one, but multiple bypasses (up to three) using arteries which can work better than veins for some people
• An ablation and left atrial appendage closure to treat atrial fibrillation
• Revascularization and stenting

"Using the robot gives the surgeon more options and more flexibility during the procedure," said Dr. Gray, cardiac surgeon with UH Harrington Heart & Vascular Institute. "Best of all, patients experience less post-operative pain, have a shorter stay in the hospital, and return to normal activities more quickly. Our ultimate goal is giving our patients healthier, fuller lives and this approach helps us achieve that."

Drs. Gray and Ruda Vega perform robotic MIDCABs at UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center. In January 2025, the team will expand to UH Lake West Medical Center in Willoughby. 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.

Photo: Dr. Kelsey Gray performing a robotic heart bypass surgery at UH Cleveland Medical Center.