Robot-assisted bypass speeds recovery time, gets patient to NASCAR race
Jay Savage is an avid NASCAR fan. A few months ago the 51-year-old bought a new motorhome and infield passes to the May race at Talladega Superspeedway. He hoped to see his favorite driver Kevin Harvick post his first victory of the season and repeat his 2010 Aaron’s 499 win. But, the need for a heart bypass operation a week before the big race nearly derailed Savage’s plans.
Then University of Alabama at Birmingham cardiac surgeon Trey Brunsting, M.D., offered Savage a minimally invasive surgery that would enable him to load his RV and head to his spot at the south tunnel — in turn No. 2 between row one and 36 — after removing the blockage in his heart.
"A traditional cardiac bypass procedure is done with an incision in the center of the chest and you separate the two halves of the breastbone, but it takes a long time for people to recover," Brunsting says. "A patient is in the hospital five to seven days and then bone has to knit back together. It takes three or four months for people to return to full activity."
That surgery certainly would have kept Savage from his NASCAR dream. But Brunsting told Savage he could repair his blocked artery and discharge him from the hospital in a few days using robot-assisted surgery.
“For about the past three and a half months I had been having pain where the shoulder strap on a seat belt goes,” Savage says. “That’s what kept bothering me, because it was up so high. I had an arteriogram, and they found a blockage. There wasn’t any other option besides cracking my chest, and I was willing to do anything to make the race.”
The blockage was at the beginning of the major artery on the front his heart where the short left main trunk splits into two, Brunsting says. “It’s a difficult place to stent, and a bypass operation was a better long-term choice for him.”
Robotic, or minimally invasive bypass operations, use a special scope system and three small port sites on the side of the chest to begin the operation and to ensure surgeons can prepare the mammary or thoracic artery on that side of the chest ready to use as a bypass graft. Then the surgeon may add two port sites and operate wholly with scopes or remove the scope and create a slightly larger incision between the ribs and do the bypass by hand - but with direct vision. UAB Hospital is the only Birmingham-area hospital providing totally endoscopic robotic heart bypass surgery -- without the extra, larger incision.
Whether doctors use the scope system or direct vision with the 3-inch incision, recovery time is dramatically shortened. With the full scope, patients are in the hospital two to three days and usually able to return to full activity in two to three weeks, Brunsting says. With the small incision, patients are in the hospital three to five days and return to full activity in four to six weeks.
Savage says he is grateful for a short recovery and not to be facing another heart attack.
“I’m glad they found this and fixed it the way they did, instead of something happening while I was out there,” Savage says. “It could have been bad. I didn’t think it was as bad as it was. I mean open heart surgery, I would have never dreamed that in my life. A stent, that’s nothing. That’s like putting a Band-Aid on it. But, cracking your chest, that’s something else. Now all I have is a little bitty scar and that’s not bad.”
As for Savage’s Talladega plans, Brunsting say while not ideal for recovery, he should be fine.
“It’s probably a little bit quick but he’s otherwise healthy and in good shape,” Brunsting says. “He’s got a motor home with air conditioning and a place to lie down if he needs to take a little bit of a break or rest, and he’s got friends and family that are going with him, so I’m actually pretty comfortable with it.”