Robotic Coronary Artery Bypass Grafting for Transplant Vasculopathy.

A 60 year old female developed Cardiac Allograft Vasculopathy (CAV) 9 years after heart transplantation and treated with drug-eluting stent (DES) in the LAD. Recurrence of in stent restenosis (ISR) was treated with another DES. Recurrent IRS was again observed and Robotic Mid-CABG surgery was successfully performed. Mid-CABG is a plausible alternative in patients with CAV and offer the excellent result of LITA to LAD graft despite a sternotomy-spare approach. This is the first case report of the adoption of this technique in a redo heart transplant patient, opening the scenario for a new tool in the treatment of CAV.