Minimally Invasive Robotic Heart Surgery: A Patient’s Journey

By: Emory Heart & Vascular
Date: Feb 1, 2022

Emory Healthcare patient Bruce Kraselsky wants anyone who needs coronary artery bypass graft (CABG) surgery to know that a much less invasive option exists, with outcomes as good or better than open-heart surgery. The successful serial entrepreneur from Northern Virginia received robotic-assisted (RA) CABG and a hybrid coronary revascularization from Drs. Michael Halkos and William Nicholson at Emory in October 2020, with a complete recovery and return to a full and active lifestyle in a fraction of the time that would have been possible with open-heart surgery.

“People need to know that minimally invasive robotic surgery is a real option if you qualify as a candidate,” says Bruce. “The technology has evolved over the last 20 years with amazing results for thousands of patients; it’s not science fiction.”

An avid tennis player, Bruce suddenly found himself three weeks away from undergoing traditional open-heart surgery after experiencing unusual exhaustion and difficulty recovering between points during a tennis match. A visit to his cardiologist and an angiogram determined that two of his main coronary arteries were almost fully blocked.

That’s when he started looking into other treatment options.

“The thought of open-heart surgery, where the surgeon cuts through your sternum, pries open your ribcage, and uses a heart-lung machine to keep blood and oxygen flowing while working on your disconnected heart, terrified me,” Bruce says. “This, along with concerns about recovery time and potential impact on my active lifestyle, including tennis, compelled me to look for viable alternatives.”

Bruce became an advocate for himself. He found a treatment option that would put him back on the tennis court in less than six weeks, instead of three to six months later with open-heart surgery. Bruce now shares his story to increase public awareness of robotic-assisted cardiac bypass surgery (RA CABG) so that others can benefit from his experience.

Motivated To Find a Better Option

Bruce is no stranger to treatments for blocked coronary arteries. In 2014, he felt shortness of breath and chest pain when playing tennis. He went to the emergency room, where doctors diagnosed 95 percent blockages in two coronary arteries.

Doctors performed angioplasty and implanted two stents to open his arteries. Bruce quickly returned to his normal activities.

“Unfortunately, my return did not include a heart-healthy diet and weight loss program to prevent the problem from happening again,” Bruce says.

In summer 2020, Bruce kept getting short of breath during his tennis games. Tests showed blockages in his left anterior descending (LAD) artery and an adjacent artery.

A blockage in the LAD artery can shut down a large portion of heart muscle. A significant blockage in this artery is called a “widowmaker” because it can result in immediate death.

His cardiologist referred him to a cardiac surgeon where open-heart surgery was recommended.

This marked the start of Bruce’s marathon medical research project. He quickly realized he needed to be his own advocate “focused on me and my well-being. Not just the clinical aspects of surgery, but how it would impact my active lifestyle.”

“When I first read about the robotic procedure, I didn’t take it too seriously because it seemed like science fiction,” Bruce says. His local cardiac surgeon did not mention it as a treatment choice either.

During a pre-op meeting for his open-heart surgery, Bruce asked the cardiac surgeon about RA CABG. That doctor confirmed it was a viable option and that he expected to start training for the procedure in the next year or so. He suggested Bruce speak to Michael Halkos, MD, MSc, chief of cardiothoracic surgery at Emory Healthcare – a leading expert in the procedure.

The Road To Atlanta

Bruce combed through research articles and medical journals. He searched Google and watched YouTube videos of the procedure – including one produced by Dr. Halkos and his team at Emory Healthcare.

“It is time-consuming and tedious, and it requires an awful lot of thought,” Bruce says. “You also have to learn to separate objective, peer-reviewed articles from marketing material. But to get a positive outcome, it’s worth it.”

Bruce learned the ins and outs of the RA CABG procedure. He learned:

Doctors have successfully used the RA CABG procedure for thousands of cardiac bypass operations in the past 20 years.

The da Vinci robot manufactured by Intuitive Surgical was the first robotic system designed for this surgery.

Studies show CABG procedures using the da Vinci robot instead of conventional open-heart surgery give patients successful outcomes, including:

Faster recovery times

Lower risks of certain complications

Less long-term pain and discomfort

“My research made it clear to me that this was my best option,” Bruce says.

Why Emory Stood Out

Bruce began searching for the best heart surgeons and hospitals in the country that specialized in robotic-assisted CABG. After narrowing his list to four hospitals and surgeons and receiving confirmation that he was a good candidate for the minimally invasive procedure, Bruce had online video/telecon consultations with those providers.

“All of the doctors are pioneers in using the da Vinci robot and all had the same amount of experience, with more than 1,000 procedures,” Bruce says.

After the online interviews, Bruce chose Dr. Halkos to perform the RA CABG and William Nicholson, MD, Director of Complex Coronary and Cardiac Intervention at Emory Healthcare, to perform the catheter-stenting HCR procedure. Both doctors have performed more than 1,000 successful operations with positive outcomes in the past 10 years.

“What set Emory apart for me was Dr. Halkos’ bedside manner and the interest he and his staff expressed when I reached out to them,” Bruce says. “They were welcoming. They took the time to communicate with me, to discuss the procedure, expected outcomes and risks in detail. They made me feel like they really cared.”

The Recovery Process

One day after his surgery, Bruce was out of bed and walking the hospital halls. He was released on day four and walked 1.5 miles with his wife in downtown Atlanta on day five.

“With minimally invasive RA CABG, you can generally expect to get out of bed, walk and tackle stairs within days and weeks,” says Dr. Halkos. “Most patients have the breathing tube removed in the operating room, many do not require an ICU stay, and generally patients are able to go home a day or two sooner than regular bypass surgery patients.”

Two weeks after surgery, Bruce and his wife flew home to Virginia. By week five, he was back on the tennis courts.

Better Shape Than Ever

Months after his surgery, Bruce plays tennis frequently and enjoys a healthier lifestyle.

“I’m not done yet,” says Bruce. “I made big changes after this procedure. Years ago, I ignored my doctor’s recommendations to change my diet and lose weight. I thought I was invincible. This time, I decided I was given another chance and I’d better make the most of it.”

Today, after more than 20 pounds of weight loss, Bruce’s routine includes:

  • Avoiding diet soda and red meat
  • Daily cardiovascular exercise
  • Eating a low-carb, low-sugar diet
  • Getting more sleep

Recent medical tests show Bruce’s heart and arteries are in better shape than they were in 2010, he says. His cholesterol numbers are excellent because of his diet and exercise. But Bruce still wonders: if he had not stumbled upon the RA CABG procedure, and instead had open-heart surgery, would he have had as successful an outcome? While he’ll never know for sure, he is grateful for his speedy recovery and for the excellent care he received at Emory Healthcare.

Comprehensive Heart and Vascular Care

If you or a loved one has a cardiovascular concern involving the heart, arteries or veins, you will want to consult with doctors who are at the top of their fields – physicians who are sought-after experts, highly skilled and leading the way to new and better methods of treating heart disease.

 

About Emory Heart & Vascular

Emory Heart & Vascular brings together more than 175 physicians, offering comprehensive medical and surgical treatments for the full range of heart and vascular conditions. The Center includes 18 specialized programs in cardiology, cardiac surgery, vascular surgery and cardiovascular imaging.

We see patients at six hospitals with more than 23 community locations. Depending on your need, we can see you as early as the next day.

For more information or to find a provider near you, call 404-778-7777.

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