Bilateral Internal Mammary Artery Harvest Using an SSi MANTRA

This article is part of CTSNet’s Guest Editor Series, “Robotic-Assisted Coronary Artery Bypass Graft Surgery—Techniques and Procedures” Dr. M. M. Yusuf brought together cardiac surgery experts from around the world to contribute procedure videos on various techniques.

Bilateral internal mammary artery harvest refers to the use of both the left and right internal mammary arteries (IMAs) for coronary artery bypass surgery (CABG). The superior long-term patency of IMA grafts is attributed to their inherent resistance to atherosclerotic development, unlike native coronary arteries and saphenous vein grafts. The left internal mammary artery is harvested first. Then, the right internal mammary artery (RIMA) is dissected with clips placed on the proximal and distal ends. The RIMA is then anastomosed to the left internal mammary artery as a Y-anastomosis to perform multivessel CABG. This video shows a surgery performed using a robotic surgical system developed in India, the SSi MANTRA. The robot offers improved precision and dexterity during minimally invasive surgery, reduces trauma to the chest wall compared to traditional open surgery, and offers faster recovery times for patients. It has the potential to make advanced surgical care more accessible and affordable to patients. 

References

1. Rajput NK, Kalangi TKV, Andappan A, Swain AK. MICS CABG: a single-center experience of the first 100 cases. Indian J Thorac Cardiovasc Surg. 2021;37(1):16-26. doi:10.1007/s12055-020-01048-2.
2. Hemli JM, Patel NC. Robotic Cardiac Surgery. Surg Clin North Am. 2020;100(2):219-236. doi:10.1016/j.suc.2019.12.005.
3. Taggart DP. Bilateral internal mammary artery grafting: are BIMA better?. Heart. 2002;88(1):7-9. doi:10.1136/heart.88.1.7.

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