Emory Healthcare collaborates with NIH to perform world’s first minimally invasive coronary artery bypass surgery

ATLANTA - A collaboration between Emory Healthcare, Emory School of Medicine and the National Institutes of Health (NIH) has led clinicians to perform the world's first minimally invasive coronary artery bypass technique without open-heart surgery.

The collective medical team included Emory cardiovascular surgeons Adam Greenbaum, MD and Vasilis Babliaros, MD as well as Christopher Bruce, MBChB, adjunct assistant professor of cardiology at Emory School of Medicine and Robert Lederman, MD, from the Laboratory of Cardiovascular Intervention at the National Heart, Lung and Blood Institute, a part of the NIH.

"This was a collaborative effort to bring an off-label use of medical devices to provide compassionate care for patients with little to no other options," says Adam Greenbaum MD, cardiologist at Emory Healthcare, and associate professor at Emory School of Medicine.

Greenbaum and Babliaros had been investigating techniques to treat structural heart disease and teamed up with Bruce and Letterman, who were also researching similar techniques in the animal lab. Together, they investigated a new way to prevent artery blockages, a rare but often deadly complication that can occur after heart valve replacement. "The animal research was translated into being accomplishable for human care," says Babaliaros, who is also a professor of medicine at Emory School of Medicine.

The high-risk novel procedure, known as VECTOR, creates a new pathway for blood to reach the heart by moving the coronary artery. Instead of opening the chest, doctors reach the heart by guiding electric wires through a catheter inserted into the groin. The wire is guided into a coronary artery that is at risk of becoming blocked, carefully steering it into a smaller branch of that artery. Using a second catheter, the physicians capture the wire and maneuver it outward through a vein in the leg. This process creates a continuous pathway through the body that allows more advanced tools to be guided precisely into place.

"Our team then creates a new, safer entrance point for blood flow to the heart using a stent to connect the openings, forming a new route for blood to travel," explains Greenbaum. "The bypass graph placement in this newly created path allows blood to flow around the problem area, providing a safe and effective alternative route that avoids the risk of blockage."

The Emory team notes the findings suggest that, in the future, people at risk of this complication may be able to receive safer, less invasive treatments. "Access to a minimally invasive alternative is vital in cases such as this. We want to offer hope for those who have no hope," says Babaliaros.