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Miami Valley Hospital Surgeon Performs First Cardio-Robotic Procedure

Robot Used for Pacemaker Lead Installation

Dayton, Ohio (August 31, 2006) - A Kettering woman is the first in the Miami Valley to undergo cardio-robotic surgery at Miami Valley Hospital for placement of a lead for a biventricular pacemaker on the posterior side of the heart that helps people with weakened hearts resume more normal activity.

Ali Zaman, MD, a cardiothoracic surgeon with Miami Valley Heart & Lung Surgeons, performed the procedure July 27th after a first attempt at traditional surgery failed because the patient's blood pressure fell to dangerously low levels prior to the operation. Dr. Zaman is trained in robotic procedures, and he was accompanied by proctors from Intuitive, makers of the DaVinci Robot at Miami Valley Hospital that was recently named "Robie the Robot" by a Dayton third-grade student. Mark Anstadt, MD, also with Miami Valley Heart & Lung Surgeons, assisted with the robotic surgery.

"This was a relatively simple procedure, and the robot enabled the precision and accuracy we need for these operations to be effective," said Ali Zaman, MD, a cardiothoracic surgeon with Miami Valley Hospital. "We look forward to using the robot more frequently and advancing to other cardiac procedures that can benefit patients with quicker recovery overall."

The robot enables more accurate placement and testing of leads, like those required in pacemaker installation, over traditional surgery because the robot can more precisely access the posterior and lateral angles required to install and test voltage of the bi-ventricular lead. What that means for the patient is less pain, quicker recovery, fewer days in hospital, no incisions or spreading of the ribs that could result in fracture, and a more successful long-term effect.

People with weakened hearts from congestive heart failure often require bi-ventricular pacemakers to help regulate the heart's pumping. Without the devices, as in the case of Shirley Nadosky, the 65-year-old who underwent the first cardio-robotic procedure, severe shortness of breath and inability to walk even short distances can be symptoms.

"I was so comfortable in the care of Dr. Zaman; he explained everything to me, and we had long conversations about how the robot would be a better choice for me with my weakened heart," said Shirley Nadosky, a patient of Dr. Zaman. "He told me he would treat me like his own mother, and he certainly did. I have no regrets, and I am feeling great. I even went to play bingo five days after my surgery!"

Traditionally, interventional cardiologists attempt to insert the pacemaker leads by traveling through arteries beginning in the groin. These procedures are commonly done in the catheterization laboratory. As in the case of bi-ventricular pacing, two leads are required for installation, and one is more challenging to accurately position long-term. That's when cardiothoracic surgeons are asked to join the medical team and operate by opening the chest cavity with a six-inch incision on the left side of the chest, spreading the ribs, and finding the membrane to expose the heart. The lead is placed on the surface of the heart at an angle that is challenging to reach because it is the posterior and lateral side of the heart muscle.

In spring this year, the first prostatectomy was performed using the robot, and more surgeons at Miami Valley Hospital are being trained to use the technology for other procedures such as gynecologic and cardiac.