TECAB reduces risk, expedites recovery for bypass patients

Mount Sinai Heart announced June 10 that a pair of its top cardiothoracic surgeons succeeded in performing two totally endoscopic coronary arterial bypass surgeries (TECABs) at the end of May, making the hospital the only center in New York State qualified to offer the procedure.

TECAB applies a highly technical approach to coronary artery bypass surgery, allowing physicians to operate through a series of micro-incisions rather than a singular 12-inch incision in a patient’s chest. At Mount Sinai, surgeons John Puskas, MD, and Gianluca Torregrossa, MD, placed robotic instruments through four keyhole incisions no more than 1 centimeter long in their patients’ chests, harvesting the mammary artery and connecting it to the coronary artery on the front wall of the heart. The physicians then fired 13 small stainless steel clips to hold the arteries together—a precise and time-saving alternative to physically sewing the arteries together by hand.

“TECAB allows us to avoid any major chest incisions for our patients, giving them a dramatic improvement in postoperative recovery,” Torregrossa, the associate director of robotic heart surgery at Mount Sinai St. Luke’s, said in a statement. “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.”

TECAB offers patients a quicker recovery, Torregrossa said—while CABG patients are typically in the hospital for 7 to 10 days post-op and can’t resume full activity for around three months, TECAB patients can expect to be discharged within four days and return to normal activities in one to two weeks. TECAB also provides a reduced risk of stroke and eliminates rib spreading.

According to Mount Sinai’s statement, a good fraction of today’s bypass patients may qualify for TECAB. The best candidates are those with a limited number of blockages of the left side of their heart; the worst are those who have had previous heart surgery or exposure to cancer radiation therapy near the chest.

“This is a very technically demanding procedure, with few bypass surgeons having enough skill or training to employ it,” Mount Sinai President Arthur Gianelli said. “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.”