Surgeon Pioneers Closed-Chest, Totally Endoscopic Coronary Artery Bypass Surgery

Coronary Artery Bypass Surgery

Coronary artery bypass surgery is being taken to a whole new level at University of Chicago Medical Center with the arrival of a new faculty member.

A pioneer in the development of minimally invasive and robotic heart surgery, Sudhir Srivastava, MD, a cardiothoracic surgeon from Odessa, Texas, has performed more than 270 totally endoscopic coronary artery bypass surgeries, far more than any other U.S. physician, using minimally invasive robotic tools that enhances precision and eliminates the need to open the chest. Worldwide, about 98 percent of all coronary artery bypasses are performed by opening up the chest, says Srivastava.

Using a daVinci surgical system robot to perform the surgery, and typically keeping the patient off a heart-lung machine, Srivastava is one of only two surgeons worldwide who has performed a large number of these complex, multi-vessel cases. "The procedure has many advantages compared to traditional coronary artery bypass surgery," he explains. Patients are usually in and out of the hospital within one to three days. They're often back to work within a week. Very little blood is required for the surgery. And the pain level is significantly lower."

The surgery is performed through four or five small holes created in the side of the chest. Using the robot allows enhanced close-up vision and precision of movement not available to the surgeon using his or her own hands or standard minimally invasive instruments to conduct the bypass surgery.

"The response from patients has been tremendous," Srivastava explains. "Patients don't like the thought of having their sternum opened. The recuperation from the minimal invasive procedures is far shorter, with lesser chance of complications.

"We've found the grafts equivalent at remaining obstruction-free when compared to coronary artery bypass surgery performed the standard way. In addition, this procedure isn't restricted to only single vessel bypass. We've used it in double and triple bypasses, too," he says.

Srivastava will begin working with University of Chicago surgeons in this technique so the Medical Center will become the leader for minimally invasive coronary bypass surgery. Meanwhile, he remains an anomaly among cardiothoracic surgeons, with patients discovering him from the Internet and coming from around the world for their bypass surgeries. Only now, those patients will have the ease of coming to Chicago, rather than Odessa, Texas, which is more difficult to reach.

Srivastava moved to Chicago with his wife, Elizabeth Srivastava, MD, a family practitioner. Their children are Vishwa, age 30 and Deepti, age 25.

He is a graduate of J.L.N. Medical College in Ajmer India in 1970. He completed general surgery and cardiovascular and thoracic surgery residencies at University of British Columbia in Vancouver and has practiced in Midland-Odessa since 1989.

Besides focusing on minimally invasive coronary artery bypass surgery, University of Chicago Medical Center has developed a reputation for implanting stents, heart valves, and other repairs using portals and robotic assistance.

"We are very fortunate to have Dr. Srivastava join us. He adds the ability to perform bypass surgery to our existing robust minimal invasive valve expertise. His addition will make us the most comprehensive minimal invasive cardiac program in the world and it's no doubt we will see the number of patients coming to us from outside of the Chicago area grow. Our intent is to be a preeminent destination for patients who want to recover faster and have little down-time for cardiac surgery," says Valluvan Jeevanandam, MD, chief of cardiac and thoracic surgery.