WVU Heart and Vascular Institute surgical team performs another world-first robotic heart surgery

MORGANTOWN, W.Va. – The multidisciplinary team at WVU Medicine’s WVU Heart and Vascular Institute (HVI) has performed another world-first robotic heart operation. Utilizing the latest advances in the robotic cardiac platform developed and led by Vinay Badhwar, M.D., heart surgeons at WVU Medicine have now performed the first-ever combined valve replacement and coronary artery bypass operation, potentially signaling a new pathway for an expansion of heart surgery done robotically. 

This recent surgical advancement follows a related procedure conducted in January 2020, when the same WVU Robotic Cardiac Program surgical team performed the first robotic aortic valve replacement operation (RAVR) via a similar tiny incision through the ribs in a patient’s right chest near the axilla, or armpit. 

A blocked or leaking valve can lead to heart failure, a stroke, or worse, often requiring surgical treatment to replace the valve. When coronary arteries are blocked, patients may experience chest pain or a heart attack. These patients often receive a stent or open-heart surgery with coronary artery bypass grafting. 

“Patients who have both valve disease and coronary artery disease have traditionally been treated by open-heart surgery performed through the breast bone,” Lawrence Wei, M.D., professor in the WVU Department of Cardiovascular and Thoracic Surgery, and one of the WVU Heart & Vascular Institute team members that helped to develop the novel approach, said.  

“Until now, the main exclusion for us to perform a robotic approach has been the coexistence of valve and coronary artery disease. Building on our experience with robotic aortic valve surgery, this new approach may help us extend robotic surgery options to many more patients,” Goya Raikar, M.D., assistant professor in the WVU Department of Cardiovascular and Thoracic Surgery and member of the robotic team, noted. 

Historically, robotic heart surgery has been performed on otherwise lower risk patients with a single heart problem in need of repair, such as the mitral valve. Since 2017, the team at WVU has helped to pioneer thoughtful use of robotic technology that can be applied to more complex patients, reducing the risk of complications and improving outcomes of heart surgery. The RAVR procedure developed at WVU is one example of an advancement in robotic surgery that is now performed in multiple institutions in several countries around the world. 

The complex problems faced by Poppy McGee, 73, left the Uniontown, Pennsylvania resident very ill for many months. Following a stroke, brain surgery, and ongoing weight loss, McGee had become quite frail. When informed that she had both a severe problem with her aortic valve and a significant blockage in her coronary artery causing her heart to fail, she and her family feared she would not be able to tolerate conventional open-heart surgery. 

Ms. McGee’s cardiologists agreed and subsequently referred her to Vinay Badhwar, M.D., executive chair of the WVU Heart & Vascular Institute and professor and chairman of the Department of the WVU Department of Cardiovascular and Thoracic Surgery. Dr. Badhwar first offered McGee conventional open-heart surgery, which in her case would have proven risky. Badhwar told McGee and her family she had just over a 10 percent chance of dying and close to a 50 percent chance of complications.  

After discussing the risks with McGee and considering her family’s request for a potentially less invasive or robotic approach, Badhwar explained that while his team had developed a new robotically performed technique to treat cases just like hers, she would be the first in the world to undergo such a procedure. Ms. McGee and her family understood the risks involved but quickly agreed. 

On October 31, 2024, McGee became the world’s first patient to undergo both an aortic valve replacement and coronary artery bypass grafting, all through a single small incision on the far right side of her chest, performed completely robotically. Not only was the surgery a technical success, but her heart’s function improved after the operation.  

“We are so thankful for Dr. Badhwar and the team at the WVU Heart and Vascular Institute developing this robotic procedure to help my mother recover so well,” said Mollie Wilcosky, Ms. McGee’s daughter. “She is getting stronger every day, and we were able to enjoy a nice Thanksgiving with her at home. I am convinced that she may not be here with us, or the outcome may have been very different, if the team at WVU had not developed this procedure.” 

“It is such an honor and privilege to work alongside the excellent team of surgeons and cardiologists at the WVU Heart and Vascular Institute. Their teamwork has enabled several innovations in robotic cardiac surgery, such as the one we used to help Ms. McGee,” Dr. Badhwar said.  

“While we are still in the early days of this latest innovation, the ability to perform valve surgery and coronary artery bypass surgery fully robotically through a single incision has the potential to open up a new era of robotic heart surgery. We must always keep quality outcomes at the forefront of all innovation. However, if surgeons adopt and gain experience with techniques such as this one, we will tackle this last frontier that previously limited a robotic approach. One day in the near future, this may serve as a platform to perform nearly all types of heart surgery.” 

In the process of publication by The Annals of Thoracic Surgery, the successful surgery was revealed to attendees at the recent WVU International RAVR Symposium, hosted by the WVU Heart & Vascular Institute in Morgantown on Nov. 14, 2024. The conference attracted experts from 16 U.S. states and 11 countries.

For more information on the WVU Heart and Vascular Institute, visit WVUMedicine.org/Heart.