By: St. Luke’s Health - The Woodlands Hospital | Published 02/19/2024
THE WOODLANDS, TX -- When Rick Woody arrived at the emergency room at St. Luke’s Health–The Woodlands Hospital in the predawn hours, he was experiencing shortness of breath, pain in his left arm and jaw and waves of nausea. The medical team quickly determined the 67-year-old Spring resident was having a heart attack. craniotomy scissors
Woody was taken to the cardiac catheterization lab, where specialists inspected the inner workings of his heart and found a blockage in the right coronary artery as well as the left anterior descending (LAD) artery, which carries nearly half of the blood to the heart. Since Woody had recently undergone hip replacement surgery at a different hospital and was still unable to walk due to severe leg swelling, doctors came up with a more personalized treatment plan. They decided on a hybrid approach utilizing stents for the immediate blockage causing the heart attack (the right coronary artery) and a bypass operation for the other artery (LAD). This approach addressed Woody’s problems while allowing him to recover from the recent hip operation.
Woody couldn’t fathom undergoing immediate bypass surgery, which commonly involves open-heart surgery and a doctor cutting through the breastbone to reach the heart.
“How can I even envision trying to survive that, because, after that surgery, you're going to want me to do some sort of rehab. I can't walk yet. I can't move my leg,” Woody told his doctors. “Is there anything else that we can do?” His team decided he was a good candidate for the first robotic-assisted coronary artery bypass graft surgery to be performed at St. Luke’s?The Woodlands. While robotic-assisted surgeries have been performed in other areas, such as abdominal surgery, for decades, those involving the heart are less common.
“There are very few robotic heart surgery programs in the U.S.,” said Vivek Patel, MD, assistant professor of surgery in the Division of Cardiothoracic Surgery at Baylor College of Medicine. “Most of the time, these are just done at larger medical centers. So, we’re proud to be able to offer it here for our patients.” Before his surgery, Woody had a procedure to stent his right coronary artery, the area that caused his heart attack. Then he went home and recovered for six weeks.
They met in the surgeon’s office to discuss the operation. During the procedure, Dr. Patel would make three small keyhole incisions on the left chest, use the left internal mammary artery for the bypass (the gold standard for bypass operations) and not have to use the heart-lung machine. This less-invasive surgery can make for a faster recovery.
“The robot is just an instrument. A lot of people think it actually does the surgery, but it's an instrument that we control,” Dr. Patel said. “It's not automated. It's simply an extension, or an instrument, of what we normally do in surgery, and it allows us to get into smaller spaces without making a big incision.” Woody knew he had to have heart bypass surgery and said it was “kind of a no-brainer” to opt for the less-invasive option. Still, the man who has spent his career working for an engine compressor manufacturer wanted to be sure the machine was up to the task since he was breaking new ground.
“The first thing I thought was, did you guys check out this machine first before you're going to put it in my chest?” Woody said. He was assured everything was functioning properly, and the surgery in November 2023 was a success.
“I felt so good because I had all this fresh blood that was coming to me. My mind was so sharp. I was ready to go. I felt 25, 30 years younger,” said Woody, who celebrated his 68th birthday on Feb. 4, 2024. Nonetheless, he still had to recover and do cardiac rehab, which is standard for most people undergoing stenting or open heart bypass surgery.
“Now I'm getting around pretty good,” he said. “I just climbed down out of my attic.” While many people want a less invasive approach, not everyone is a candidate for this type of surgery.
“We select these on a case-by-case basis based on the patient's anatomy and what they need,” Dr. Patel said. The surgery is typically for people needing one or two vessels bypassed and is good for higher-risk patients who can’t undergo an open-heart bypass operation, he said.
“Stents, robotic-assisted coronary artery bypass surgery and open heart bypass surgery are all great treatment options for those with coronary artery heart disease. We decide on the approach together as a team based on the patient’s anatomy and functional status,” Dr. Patel said.
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